Ten Practical Tips for a Best Possible Medication History
By Wenya Miao, Chris Fan-Lun, on No Comments / 3216 views
Wenya Miao (BScPhm, PharmD, ACPR) and Chris Fan-Lun (BScPhm, ACPR, BCGP) , pharmacists at Mount Sinai Hospital in Toronto share how to obtain a Best Possible Medication History (BPMH) in the ED, and provide an example BPMH script to follow.
Be proactive. Gather as much information as possible prior to seeing the patient. Include primary medication histories, provincial database information, and medications vials/ lists.
Prompt questions about non-prescription categories: over the counter drugs, vitamins, recreational drugs, herbal/traditional remedies.
Prompt questions about unique dosage forms: eye drops, inhalers, patches, and sprays.
Don’t assume patients are taking medications according to prescription vials. Ask about recent changes initiated by either the patient or the prescriber.
Use open-ended questions: “Tell me how you take this medication?”
Use medical conditions as a trigger to prompt consideration of appropriate common medications: “When you get short of breath, what medications do you take?”
Consider patient adherence with prescribed regimens: “Has the medication been recently filled?”
Verify accuracy: validate with at least two sources of information.
Obtain community pharmacy contact information: anticipate and inquire about multiple pharmacies.
Use a BPMH trigger sheet or a systematic process /interview guide like the one found here. Include efficient order/optimal phrasing of questions and prompts for commonly missed medications