Inpatient medication history verification by pharmacy students

Purpose. The ability of pharmacy students to improve the accuracy of patients' medication histories was studied. Methods. This prospective study was conducted between January and April 2007 at a 424-bed community teaching hospital. Pharmacy students were assigned one or two patients daily admitted to the inpatient internal medicine service and were required to perform a thorough medication history for each. Patients were included in the study if a medication history was performed and recorded on the medication reconciliation form. Students were instructed to obtain medication histories by interviewing the patient, a family member, or both and calling the patient's community pharmacy to verify all medications. If there were any discrepancies between these sources of information and the initial medication reconciliation form, the information was reconfirmed with the patient. Any information obtained by the students that had not already been documented on the medication reconciliation record was updated in the patient's chart. Results. A total of 326 charts were included in this analysis. Student-obtained medication histories resulted in the addition of previously undocumented prescription medications to 175 charts (53.7%) and nonprescription medications or natural products to 167 charts (51.2%). Calling the patients' community pharmacy helped to identify omissions or discrepancies approximately 75% of the time. Overall, the students improved the accuracy of medication histories for 220 (67%) of the 326 patients. Conclusion. Pharmacy students' participation in obtaining medication histories improved the completeness and accuracy of patient medication records.