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

2014 
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.
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