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Title: Accuracy of medication histories derived from an Australian cloud-based repository of prescribed and dispensed medication records.
Austin Authors: Elliott, Rohan A ;Taylor, Simone E ;Koo, Stella Mk;Nguyen, Anny D;Liu, Esther;Loh, Grace
Affiliation: Pharmacy..
Pharmacy Department, Eastern Health, Melbourne..
Pharmacy Department, Peninsula Health, Melbourne..
Issue Date: 20-Jun-2022
Date: 2022-06-20
Publication information: Internal Medicine Journal 2022; online first: 20 June
Abstract: Obtaining accurate medication histories at transitions of care is challenging, but important for patient safety. Prescription exchange services (PES) securely transfer electronic prescription and dispensing records between prescribers and pharmacies; potentially useful data for determining medication histories. To evaluate the accuracy of PES-derived medication histories. Prospective observational study, at two Australian tertiary-referral health-services. A convenience sample of adult inpatients was recruited. The main outcome measure was: proportion of patients with ≥1 errors in their PES-derived pre-admission medication histories, compared to gold-standard best-possible medication histories, including prescribed and non-prescribed medications, obtained by pharmacists using multiple sources including patient/carer interview. 153/154 (99.4%) patients (median age 76years, inter-quartile range [IQR] 64-84years, median 10.0 pre-admission medications, IQR 6.0-14.0) had ≥1 errors in their PES-derived medication history (median 6.0 per patient, IQR 4.0-9.0). Excluding when-required (PRN) medications, 146 (94.8%) patients had a median of 4.0 errors (IQR 2.0-6.0). Omission was the most common error, affecting 549/1648 (33.3%) current medications (median 3.0, IQR 1.0-5.0 per patient); 396 [72.1%] omissions were over-the-counter medicines. Dose-regimen errors affected 276/1099 (25.1%) current medications captured in PES-derived medication histories (median 1.0, IQR 0.0-3.0 per patient). Commission errors (medications in PES-derived histories that weren't current) affected 224/1383 (16.2%) medications (median 1.0, IQR 1.0-2.0 per patient). Medication histories derived solely from a cloud-based medication record repository had a high error rate compared to patients' actual medication use. Like all medication history sources, data from cloud-based repositories need to be verified with additional sources including patients and/or carers. This article is protected by copyright. All rights reserved.
DOI: 10.1111/imj.15857
ORCID: 0000-0002-7750-9724
Journal: Internal Medicine Journal
PubMed URL: 35719101
PubMed URL:
Type: Journal Article
Subjects: Electronic Health Records
Electronic Prescribing
Medication Reconciliation
Medication errors
Pharmaceutical Preparations
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