DRUG HISTORY TAKING AND THE IDENTIFICATION OF DRUG-RELATED PROBLEMS IN AN ACCIDENT AND EMERGENCY DEPARTMENT

Objective-To determine the incidence of drug related problems that fai l to be noted on casualty cards in patients subsequently admitted, and to compare medication histories as recorded by accident and emergency (A&E) senior house officers (SHOs) and a pharmacist. Methods-An initi al retrospective survey of 1459 acute inpatient admissions through A&E over a three month period was followed by a prospective study of 33 e lderly patients. Results-In the retrospective survey, 52 medication re lated problems were confirmed after examination of the medical records , of which only 16 were identified in A&E. In the prospective study, 1 25 currently prescribed items were identified by the pharmacist compar ed to 77 by A&E SHOs; 66% of the missed information was clinically rel evant. Of 17 previous adverse drug reactions identified by the pharmac ist only six were also recorded by the A&E officer. Only four over the counter medicines were identified by the A&E SHOs compared to 30 by t he pharmacist. Conclusions-More accurate recording of drug history on casualty cards should be undertaken, particularly in respect of over t he counter medication and the identification of drug related problems.