Accuracy of general practitioner medication histories for patients presenting to the Emergency Department

• Published in: Australian family physician Vol. 43; no. 10; pp. 728 - 732
• Main Authors: Taylor, Simone, Welch, Susan, Harding, Andrew, Abbott, Leonie, Riyat, Baljit, Morrow, Mel, Lawrence, Dona, Rodda, Sheridan, Heward, Sarah
• Format: Journal Article
• Language: English
• Published: Australia Copyright Agency Limited (Distributor) 01-10-2014
• Subjects: Accuracy; Aged; Aged, 80 and over; Australia; Continuity of care; Emergency medical care; Emergency medical services; Emergency Service, Hospital - trends; Family medical history; Family physicians; Female; General Practitioners - standards; Humans; Male; Management; Medical history taking; Medical records; Medical referrals; Medication Errors; Medication Reconciliation - standards; Middle Aged; Patient Safety - standards; Pharmaceutical industry; Physicians (General practice); Prospective Studies; Referrals; Australia
• ISSN: 0300-8495; 2208-7958

Background: Clinical handover and obtaining best possible medication histories (BPMH) at transition points in care are key patient safety priorities. This study aimed to determine the accuracy of medication histories documented on general practitioner (GP) referral letters for patients referred to emergency departments. Methods: This was a multicentre prospective observational study in eight emergency departments. Patients taking >=1 regular medication, referred to the emergency department with a GP letter and seen by a pharmacist were included. GP medication regimens were compared with BPMH documented by the emergency department pharmacist. Results: Of the GP letters (total 414), 361 (87%) had one or more discrepancies in the patients' regular medications and 62% had one or more regular medication discrepancies of moderate-high significance. Omission of medication was more prevalent in handwritten letters (P <0.001), whereas inclusion of medications not taken was more prevalent in electronically generated letters (P <0.001). Discussion: GP referral letters should not be used in isolation to determine the medication regimen taken before an emergency department presentation. Interventions are indicated to improve awareness and accuracy of medication documentation.