Medication History Interview.pptx

Medication History Interview

1. Medication History Dr. Ajith JS Asst. Professor Department of Pharmacology Sanjivani College of Pharmaceutical Education & Research, Kopargaon

2. Definition Medication history interview (MHI) is defined as obtaining accurate information on patients’ medication use that may assist in the overall healthcare of the patient.

3. Purpose To gather all relevant information that could influence drug selection including presenting complaints and past medical history

4. Goal The ultimate goal of medication history interview is to individualize the medication order to ensure the rational drug use. This can be achieved by: Gathering the accurate and relevant information on medication use Comparing the obtained information with the information collected by the other healthcare professionals

5. Assessing the information for its appropriateness in relation to every aspect of drug use Assessing the patient’s attitude towards the drug therapy Assessing the need for medication counselling and medication aids

6. Significance It enables the pharmacists to: Establish the rapport with the patient Explain their role in the patient management Conduct preliminary medication counseling Plan the ongoing patient management / pharmaceutical care

7. Source Patients’ medication history can be obtained from Patients Carer Records compiled by the other HCP

8. Aspects to be assessed History of previous allergies and/or ADRs Indication / purpose of drug use Dosing regimen Perceived efficacy of each drug Perceived side-effects Adherence to drug regimen Potential drug – drug or drug food interactions Drug administration techniques Use of medication aids Treatment with other system of medicines (e.g., Ayurveda, Siddha and Unani )

9. Use of prescription and /or non prescription medications Specific problems relating to medication use Immunization status (if relevant) Possibility of pregnancy in women of childbearing age Social drug use (alcohol, tobacco, pan masala etc ) Evidence of drug abuse General attitudes towards illness and medication use

10. Procedure (general) The nature of the patients’ medication history interview will depend upon the individual patient To the extent possible, ask open ended questions rather than asking closed ended questions Initial patient interaction should occur by appointment in a private, professional environment Assess the patients’ understanding and attitude towards their medications and health condition

11. Patient must be treated with respect during pharmacist-patient interaction Pay special attention to what the patient is saying and tailor the responses to their comments Encourage the patient to speak more, and carefully listens and observe The data collected should be compared with the medication administration record for any discrepancies, and also to identify any drug related problems

12. Steps involved in MHI Steps to be followed while interviewing Patient selection Self-preparation Self introduction Conduct interview Conclusion Documentation

13. Patient selection Ideally patient medication history should be taken for all patients If this is not possible, prioritize patient selection But may not be possible in certain cases e.g., patients with psychiatric disorders, impaired cognition

14. Self-preparation Before commencing an interview Collect all relevant data from the various sources available Have a thorough understanding about the patients’ disease and medications

15. Privacy & Confidentiality Consider the factors related to privacy and confidentiality of interviews Make sure that none other than the pharmacist and patient present in the room so as to make the patient to feel comfortable Try to instill confidence in the patient to facilitate an effective exchange of information

16. Purpose of interview Explain the patients about the purpose of conducting interview Likely benefits that the patients might obtain from interview However the pharmacist should respect the patient’s rights to decline an interview

17. Conduct of Interview Use of communication principles such as listening, body language, voice intonation, and history taking skills is crucial to a successful patient interaction Adopt suitable position to enable the conversation to take place comfortably and effectively Communicate to patients with the language which the patients can understand Ask open-ended questions Ask questions and receive information in a nonjudgmental way (E.g. ‘Please tell me how you take your medications’ rather than asking ‘Do you take your medication as prescribed by your doctor?’).

18. Conclusion At the end of interview ascertain whether all the important and relevant information are obtained or not Summarize the important information for the patient Ask patients if they have any questions related to their medications Encourage the patients to provide more information, which may be recalled after the interview Finally inform the patient regarding when the next opportunity will arise for the further review and discussion

19. Documentation Document all the information obtained during MHI to Utilize the gathered data in the ongoing pharmaceutical care Provide readily available information that is needed for HCP Compare the documented reference with information obtained from the other HCP for any discrepancies Identify and assess medical problems