Relative accuracy and availability of an Irish National Database of dispensed medication as a source of medication history information: observational study and retrospective record analysis
Article first published online: 27 JAN 2013
© 2013 Blackwell Publishing Ltd
Journal of Clinical Pharmacy and Therapeutics
Volume 38, Issue 3, pages 219–224, June 2013
How to Cite
Grimes, T., Fitzsimons, M., Galvin, M. and Delaney, T. (2013), Relative accuracy and availability of an Irish National Database of dispensed medication as a source of medication history information: observational study and retrospective record analysis. Journal of Clinical Pharmacy and Therapeutics, 38: 219–224. doi: 10.1111/jcpt.12036
- Issue published online: 21 APR 2013
- Article first published online: 27 JAN 2013
- Manuscript Accepted: 26 NOV 2012
- Manuscript Received: 9 AUG 2012
- medical history taking;
- medical informatics;
- medication errors;
- medication reconciliation;
What is known and Objective
The medication reconciliation process begins by identifying which medicines a patient used before presentation to hospital. This is time-consuming, labour intensive and may involve interruption of clinicians. We sought to identify the availability and accuracy of data held in a national dispensing database, relative to other sources of medication history information.
For patients admitted to two acute hospitals in Ireland, a Gold Standard Pre-Admission Medication List (GSPAML) was identified and corroborated with the patient or carer. The GSPAML was compared for accuracy and availability to PAMLs from other sources, including the Health Service Executive Primary Care Reimbursement Scheme (HSE-PCRS) dispensing database.
Some 1111 medication were assessed for 97 patients, who were median age 74 years (range 18–92 years), median four co-morbidities (range 1–9), used median 10 medications (range 3–25) and half (52%) were male. The HSE-PCRS PAML was the most accurate source compared to lists provided by the general practitioner, community pharmacist or cited in previous hospital documentation: the list agreed for 74% of the medications the patients actually used, representing complete agreement for all medications in 17% of patients. It was equally contemporaneous to other sources, but was less reliable for male than female patients, those using increasing numbers of medications and those using one or more item that was not reimbursable by the HSE.
What is new and conclusion
The HSE-PCRS database is a relatively accurate, available and contemporaneous source of medication history information and could support acute hospital medication reconciliation.