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Published on: August 30, 2018
Frequency of incomplete medication histories obtained at triage
Greene Shepherd1, Richard B Schwartz
1Department of Emergency Medicine, Medical College of Georgia, University of Georgia, 1120 15th Street, Augusta, GA 30907, USA. jshepherd@mcg.edu
Purpose:
The frequency of incomplete medication histories obtained at triage in an emergency department (ED) is described.
Methods:
The survey of medication histories collected during ED triage was conducted during a 20-week period. Data collection occurred on weekdays during the dayshift for 15 hours per week for a total of 300 hours. Patients who bypassed triage or were unconscious, unable to communicate, uncooperative, or violent were excluded. Ten student pharmacists were trained on study procedures and collected data using a data collection tool which included patient's chief complaints, medications and dosages, and whether medications were identified at triage. Patients' medication-related ED visits were classified as being caused by adverse effects, medication errors, poor adherence, intentional overdose, or therapeutic failure.
Results:
During the 300 hours of data collection, 2063 patients were admitted to the ED. Of these, 1465 (71%) were interviewed and evaluated for complete medication histories. Among 1172 (80%) patients identified as taking medications, the history obtained at triage failed to identify at least one medication in 707 (48%) patients. In cases where medications were not identified, a mixture of prescription (73%) and nonprescription (27%) medications were missed with a median of 2 drugs (range, 1-20 drugs). Drugs missed at triage were related to the patient's chief complaint in 27% of the cases.
Conclusion:
Medication histories collected at triage in the ED of an urban medical center were often incomplete, especially among patients taking multiple medications. Efforts should be taken to improve methods for obtaining more complete medication histories during triage and collecting supplemental medication histories to ensure appropriate emergency care.
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