Medication history taking

Question 1

Why is it important to take extensive medication history taking?

Answer 1

• Medicine optimisation for person centred approach for safe and effective medicines for best outcomes (NICE 2015)
• 30-70% have error or unintentional change in medicines when moving care setting (NICE 2015)
• Inappropriate prescribing decisions
• Overlooking ADR (adverse drug reactions)
• Omitted and delayed dose
  Avoid cancellation/delay of procedures

Question 2

List some of the questions that should be asked when taking a medication history?

Answer 2

1. Current medication
2. Dosage (how many?, how often?, when was last time?)
3. Form (eg. Tablet, spray, liquid)
4. Strength (eg. Sustained release vs more often)
5. Frequency (often they actually take)
6. Indication (What its prescribed for?)
7. Recently stopped (still in system? Active half life?)
8. Past medication and treatment failures (if past ones have not worked or some are more effective for that patient)
9. Non-oral medication (eg. Creams, patch’s and sprays,)
10. Purchased drugs (over the counter medication)
11. Recreational drugs (interact with other medication or cause symptoms)
12. Herbal remedies (eg. Effects the liver)
13. Adverse reactions
14. Allergies and sensitivity (with clinical details) (what reaction do they actually have)
15. Document any discrepancies
16. Non-adherence – what don’t you get along with/ what aren’t you taking
17. Storage – how are you storing the medication
18. Expiration dates – make sure aware
19. Follow up – if they are getting side effects, if they need any checks eg. BP along the line.

Question 3

What is the best method for medication use?

Compliance - Adherence - Concordance

Answer 3

Concordance
- referring to the agreement and harmony between patients and HCP
- Active cooperation with patient

Question 4

What are some reasons a patient wouldn’t take medication?

Answer 4

1. Side effects not liked
2. Choosing when to take it – don’t need it all the time
3. They don’t think the medication is working so stop
4. Misunderstand what it does/ method of use
5. Advice from friends and media
6. Costs
7. Forget to take the medication