Impact of a pharmacist-led medication history program at a community hospital emergency department

Document Type


Conference Title/Conference Publication

American College of Clinical Pharmacy (ACCP) 2020 Annual Meeting



Conference Dates

October 19-30, 2020

Date of Presentation



Introduction: It is crucial to obtain an accurate medication use history(MH) in the emergency department (ED), because erroneous MH can cause inappropriate medication use during hospitalization and adversely affect the patient safety. However, little is known regarding the medication errors identified by pharmacists in ED, when for the same patient MH was conducted in a recent past by another provider. Research Question or Hypothesis: What are the types and severity of medication errors identified by pharmacists at a hospital ED, when for the same patient MH was conducted 14-days prior by another healthcare provider? Study Design: Descriptive Study Methods: Pharmacists conducted MH with patients presenting to the Yavapai Regional Medical Center (YRMC) ED between 03/14/2018and 06/20/2018. The YRMC and affiliated clinics share a common electronic health records system, including medication information. The MH data obtained by a pharmacist at the YRMC ED were included in this study for patients whose MH was previously obtained by another provider at a YRMC location within 14 days. The types and severity of medication errors were recorded, and descriptive statistics was used to analyze the parametric data. Results: Pharmacists reviewed 4094 medications for 316 patients and identified total 2554 medication errors, from which 1692, 298 and564 were mild, moderate and severe errors, respectively. The number of most common error types were: 615 drug-drug interactions, 547 drug omissions, 481 drug commissions, 415 wrong frequencies and 367 incorrect doses. The pharmacists identified 8.2, 9.8 and 7.6 medication errors per patient, whose MH was conducted 14-days prior by physicians, mid-level practitioners or non-mid-level practitioners, respectively. Conclusion: The pharmacists-led MH program identified a number of medication errors at the hospital admission for patients whose medi-cation history was recently obtained by a non-pharmacist provider. These findings support greater involvement of pharmacists for con-ducting MH in the hospital ED.

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