Assessment of the impact of patient-completed medication questionnaires on best possible medication history completion times in admitted emergency department patients

Abstract

Background: Medication errors represent one of the top medical errors that compromise patient safety. Pharmacist-led medication reconciliation (med rec) is the gold-standard and a crucial service in hospitals, which has been shown to reduce unintentional medication errors at care transitions. Studies have shown that patient medication questionnaires are reliable and compare favourably to pharmacy lists; however, there is a paucity of evidence describing the utilization of these questionnaires prior to a pharmacist’s interview as a tool to support best possible medication history (BPMH) gathering. Objective: The primary objective of this study is to determine if a patient-completed medication questionnaire available on patient interview would reduce the total time taken by the pharmacist to complete a BPMH. Secondary objectives were to determine if a reduction in time is apparent across certain patient subgroups including age, use of compliance packaging, number of medications, Canadian Triage & Acuity Scale score on admission, dispensing record available prior to interview, and admitting service. Methods: This was a prospective, non-blinded, quasi-experimental trial conducted at a single centre. Over a period of 4 weeks, eligible patients were randomized to either receive a BPMH questionnaire prior to an interview with a pharmacist or not (usual care). Data gathering, interview, and travel times were self-recorded by the completing pharmacist. Results: Nineteen patients were included in this study. None of the pre-specified endpoints met statistical significance. The median total BPMH time was 27 minutes in the control group and 50 minutes in the intervention group (p=0.089). Secondary objectives could not be evaluated due to limited sample size. Conclusion: This study does not support the use of a patient-completed medication questionnaire to improve BPMH times in emergency department patients. Extenuating circumstances prevented the capture of enough patients for meaningful analysis. Further studies are required to effectively evaluate the impact and role of questionnaires in BPMH gathering.