Medication History Interview.ppt

Medication History Interview- Introduction
Definition
Goal
Need for the patient medication history interview
Medication interview forms.

1. Medication History Interview
Mr. Ravinandan A P
Asst. Prof.
Department of Pharmacy Practice
Sree Siddaganga College of Pharmacy
Tumkur, Karnataka

2. Presentation outlines
1.Introduction
2.Definition
3.Goal
4.Needforthepatientmedicationhistory
interview
5.Medicationinterviewforms.

3. Definition
•Medicationhistoryinterview(MHI)
isdefinedasobtainingaccurate
informationonpatients’medication
usethatmayassistintheoverall
healthcareofthepatient.

4. •Amedicationhistoryisadetailed,accurateand
completeaccountofallprescribedandnon-
prescribedmedicationsthatapatienthadtaken
oriscurrentlytakingpriortoanewlyinitiated
institutionalizedorambulatorycare.
•Itprovidesvaluableinsightsintopatients’allergic
tendencies,adherencetopharmacologicaland
nonpharmacologicaltreatments,socialdruguse
and probableself-medicationwith
complementaryandalternativemedicines.
•Interviewingapatientincollectingthedata
medicalhistoryiscalledmedicationhistory
interview.

6. Goal
Theultimategoalofmedicationhistoryinterviewistoindividualize
themedicationordertoensuretherationaldruguse.Thiscanbe
achievedby:
•Gatheringtheaccurateandrelevant
informationonmedicationuse
•Comparingtheobtainedinformationwiththe
informationcollectedbytheotherhealthcare
professionals

7. Goal
Assessingtheinformationforits
appropriatenessinrelationtoeveryaspectof
druguse
Assessingthepatients’attitudetowardsthe
drugtherapy
Assessingtheneedformedicationcounselling
andmedicationaids

8. •Themedicationhistoryisavitalsourceofdatawhichis
essentialindevelopingarobustpharmacycareplan.
•Obtaininganaccurateandcompletemedicationhistory
fromapatientrequiresseveralcommunication
techniquesandmustbeadaptedforspecificpatient
characteristics.

9. Need for
Medication history interview
Itenablesthepharmaciststo:
Establishtherelationshipwiththepatient
Explaintheirroleinthepatientmanagement
Conductpreliminarymedicationcounseling
Plantheongoingpatientmanagement/
pharmaceuticalcare
Helpustoidentify&decreasedrugrelated
problems
Helpustounderstandpatientmedical
conditions
Avoidmedicationserrorsintreatment
Patientconditionscanbeimprove

10. Source
Patients’medicationhistorycanbeobtainedfrom
•Patients
•Carers
•Recordscompiledbytheother
HealthCareProfessionals(HCP)

11. Aspects / parts to be assessed
Historyofpreviousallergiesand/orADRs
Indication/purposeofdruguse
Dosingregimen
Perceivedefficacyofeachdrug
Perceivedside-effects
Adherencetodrugregimen
Potentialdrug–drugordrugfoodinteractions

12. Aspects / parts to be assessed
•Drugadministrationtechniques
•Useofmedicationaids
•Treatmentwithothersystemofmedicines
(e.g.,Ayurveda,SiddhaandUnani)
•Useofprescriptionand/ornonprescription
medications
•Specificproblemsrelatingtomedicationuse
•Immunizationstatus(ifrelevant)
•Possibilityofpregnancyinwomenof
childbearingage
•Socialdruguse(alcohol,tobacco,panmasala
etc)
•Generalattitudestowardsillnessand
medicationuse

13. Medication History Interview Form

14. Procedure (general)
•Thenatureofthepatients’medicationhistory
interviewwilldependupontheindividualpatient
•Totheextentpossible,askopenendedquestions
ratherthanaskingclosedendedquestions
•Initialpatientinteractionshouldoccurby
appointmentinaprivate,professional
environment
•Assessthepatients’understandingandattitude
towardstheirmedicationsandhealthcondition

15. Procedure (general)
•Patientmustbetreatedwithrespectduring
pharmacist-patientinteraction
•Payspecialattentiontowhatthepatientis
sayingandtailortheresponsestotheir
comments
•Encouragethepatienttospeakmore,and
carefullylistensandobserve
•Thedatacollectedshouldbecomparedwiththe
medicationadministrationrecordforany
discrepancies,andalsotoidentifyanydrug
relatedproblems

16. Steps involved in MHI
Steps to be followed while interviewing
1.Patient selection
2.Self-preparation
3.Self introduction
4.Conduct interview
5.Conclusion
6.Documentation

17. Patient selection
•Ideallypatientmedicationhistoryshouldbe
takenforallpatients
•Ifthisisnotpossible,prioritizepatient
selection
•Butmaynotbepossibleincertaincasese.g.,
patientswithpsychiatricdisorders,impaired
cognition

18. Self-preparation
Beforecommencinganinterview
•Collectallrelevantdatafromthevarious
sourcesavailable
•Haveathoroughunderstandingaboutthe
patients’diseaseandmedications

19. Privacy & confidentiality
•Considerthefactorsrelatedtoprivacyand
confidentialityofinterviews
•Makesurethatnoneotherthanthe
pharmacistandpatientpresentintheroom
soastomakethepatienttofeelcomfortable
•Trytoinstillconfidenceinthepatientto
facilitateaneffectiveexchangeof
information

20. Purpose of interview
•Explainthepatientsaboutthepurposeof
conductinginterview
•Likelybenefitsthatthepatientsmightobtain
frominterview
•Howeverthepharmacistshouldrespectthe
patient’srightstodeclineaninterview

21. Conduct of interview
•Useofcommunicationprinciplessuchaslistening,
bodylanguage,voiceintonation,andhistory
takingskillsiscrucialtoasuccessfulpatient
interaction
•Adoptsuitablepositiontoenabletheconversation
totakeplacecomfortablyandeffectively

22. Conduct of interview
•Communicatetopatientswiththelanguagewhich
thepatientscanunderstand
•Askopen-endedquestions
•Askquestionsandreceiveinformationina
nonjudgmentalway(E.g.‘Pleasetellmehowyou
takeyourmedications’ratherthanasking‘Doyou
takeyourmedicationasprescribedbyyour
doctor?’).
•Askquestionswhichareappropriateandrelevant
tothepatientmedicalcondition
•Exhaustiveinterviewandunimportantquestions
needtobeavoidedasthesemaybecounter
productive

23. Information to be obtained
Historyofpreviousallergiesand/or
ADRs
Indication/purposeofdruguse
Dosingregimenincludingdose,route,
frequencyanddurationoftherapy

24. Information to be obtained
Perceived efficacy of each drug
Perceived side effects
Adherencetodrugregimen
Prescriptionand/ornonprescription
medicationuse

25. Information to be obtained
Immunization status
Possibility of pregnancy in woman of
childbearing age
Social drug use (alcohol, tobacco)

26. Conclusion
•Attheendofinterviewascertainwhetherall
theimportantandrelevantinformationare
obtainedornot
•Summarizetheimportantinformationforthe
patient

27. Conclusion
•Askpatientsiftheyhaveanyquestions
relatedtotheirmedications
•Encouragethepatientstoprovidemore
information,whichmayberecalledafter
theinterview
•Finallyinformthepatientregardingwhen
thenextopportunitywillariseforthe
furtherreviewanddiscussion

28. Documentation
Documentalltheinformationobtainedduring
MHIto
•Utilizethegathereddataintheongoing
pharmaceuticalcare
•Providereadilyavailableinformationthatis
neededforHCP

29. Documentation
•Comparethedocumentedreferencewith
informationobtainedfromtheotherHCPforany
discrepancies
•Identifyandassessmedicalproblems

30. Thank
you