W3 PAPE drug history taking

Question 1

What is Drug/Medication History?

Answer 1

History/Background of medication taken by the patients
* Prescribed medicines – Hospital, GP, Dentist
* Over the counter purchases
* Privately prescribed or purchased
* Herbal/ Supplements/Vitamins
* Illicit drugs
* Small part of overall patient history/information gathering
* BUT – Vital skill for pharmacists
* Transfer of patients between care settings
* Patients take many medications –
Polypharmacy
* Often not all information regarding
medicines taken is transferred fully/properly between settings

Question 2

What information do you think is included in a good Drug History?

Answer 2

• Current medication taken
• Recent or previously taken medication
• Allergies to medicines
• History of Adverse Drug Reaction
• OTC Medicines taken
• Herbal/Supplements/Vitamins
• Vaccine history – Particularly important in children
• Online purchases – Rise of online pharmacies/GPS e.g. Weight loss treatments
• Illicit drug use, alcohol, tobacco
• Adherence to medicines taken – Patient understanding of medicines. Are they taking it and how are they taking it?

Question 3

How to take a drug history? ( 5 steps)

Answer 3

1. Name and dose of all medications the patient is currently taking AND how does
   the patient take it?
2. Patient compliance
3. Is the patient having any problems with their medication?
4. Does the patient have support with any of their medication?
5. Allergies

Question 4

What are the consequences of a
poor/inaccurate drug history?

Answer 4

Errors
- Drugs omitted – Prescribed/OTC
- Medicines prescribed by specialist hospital services e.g. Renal Team

Not having full history could impact treatment efficacy or lead to incorrect diagnosis or unnecessary treatment
- e.g. pt experiencing SEs from an unknown drug

Drug interactions
- Lack of detail of Allergies/Not checked for allergy
* PATIENT HARM

Question 5

What are the skills needed to take a good history?

Answer 5

Communication / Consultation Skills
* Friendly/approachable
* Open questions
* Closed questions to get more specific information
* Avoid medical jargon
* Active listening
* No interruption
* Eye contact
* Comfortable environment for patient
* Exploration of poor responses