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    Add as FriendPatient Medication History Interview

    by: Gaurav

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    1 : Patient medication history interview Gaurav Bhatia Pharm D[P.B] Poona College of Pharmacy, Pune
    2 : Introduction The medication history interview is a vital tool the pharmacist can use to gather information and improve overall patient outcomes. It affords the pharmacist insight into the patient's medication taking experiences share this valuable information with other health care professionals - they make important contributions to the health care team.
    3 : METHODS Questionnaire Development Recording accurate medication histories is an important part of the initial patient assessment after admission into a hospital. The inability to accurately identify medications taken at home and allergy information may result in considerable time and effort wasted and medication errors. A streamlined process - more efficient and improves patient safety.
    4 : A patient's home medication regimen is often continued during hospitalization. These medications are identified by the medication histories taken by a physician or nurse at admission.
    5 : Opening the Interview It is important to begin each medical interview with a patient-centered Set the Stage Welcome the patient - ensure comfort and privacy Know and use the patient's name - introduce and identify yourself
    6 : Set the Agenda Use open-ended questions initially Negotiate a list of all issues - avoid detail! Chief complaint(s) and other concerns Specific requests (i.e. medication refills) Clarify the patient's expectations for this visit - ask the patient "Why now?"
    7 : Elicit the Patient's Story Return to open-ended questions directed at the major problem(s) Encourage with silence, nonverbal cues, and verbal cues Focus by paraphrasing and summarizing
    8 : Make the Transition Summarize the interview up to that point Verbalize your intention to make a transition to the pharmacist-centered interview
    9 : Goal The info gathered can be utilized to- Verify med history with medication order- discrepancy Compare histories taken by allied staff- add info Document allergy, ADRs Screen drug interactions Assess compliance Assess rationale for drugs prescribed Assess any drug abuse Drug administration techniques
    10 : Past Medical History (PMH) This should include any illness (past or present) for which the patient has received treatment. Start by asking the patient if they have any medical problems. If you receive little/no response, the many questions can help uncover important past events
    11 : If you receive little/no response Have they ever received medical care? If so, what problems/issues were addressed? Was the care continuous or episodic? Ever been hospitalized? If so, for what?
    12 : Provides opportunity for pharmacist To- Establish rapport with patient- role in patient care Preliminary counseling- quality drug use Base- pharmaceutical care plan
    13 : Documentation relevant to medication history interview Current medication record Previous prescriptions Current admission details Referral letter from local doctor Patient’s own medication list
    14 : Seek information on following aspects Prescription medication use Non prescription medication use Allergy, ADRs Use of alternative therapies Social drug use- alcohol, tobacco Illicit drug use Immunization status
    15 : Assess patient’s understanding and attitude to their therapy Patient’s perception of purpose and effectiveness of medication Dose and dosage schedule used Duration of therapies used General impression on compliance Reason for discontinuation or alteration Storage of medicines Any problems with medication therapy
    16 : Conclusion of interview Summarize Ask for any questions Encourage the patient to give further info- tel no. contact details Give an idea regarding next meet Encourage patients to keep an up to date medication list and/or write one out for them. When all else fails, ask the patient to bring their meds/Drug
    17 : Alternative to patient Relative, care taker Community pharmacy General practitioner Nursing home staff
    18 : Social History Alcohol Intake Cigarette smoking Other Drug Use Marital Status Sexual History Work History Other …. travel
    19 : Smoking History Have they ever smoked cigarettes? If so, how many packs per day and for how many years? If they quit, when did this occur? Pipe, chewing tobacco use should also be noted.
    20 : Alcohol Do they drink alcohol? If so, how much per day and what type of drink? Encourage them to be as specific as possible. If they don't drink on a daily basis, how much do they consume over a week or month?
    21 : Other Drug Use Any drug use, past or present, should be noted. Remind these questions to assist you in identifying risk factors for particular illnesses (e.g. HIV, hepatitis). Respect their right to privacy and move on.
    22 : Work/Hobbies/Other What sort of work does the patient do? Have they always done the same thing? Do they enjoy it? If retired, what do they do to stay busy? Any hobbies? Participation in sports or other physical activity? Where are they from originally?
    23 : Family History Arthritis Cancer TB Stroke Diabetes High Blood Pressure
    24 : Review of Systems Questions about common symptoms in each major body system which may help to identify problems that the patient has not mentioned Characterize patient's overall health status Review systems/symptoms from head to toe
    25 : THANK YOU!@

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