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Medication Reconciliation: Comparing a Customized Medication History Form to a Standard Medication Form in a Specialty Clinic (CAMPII 2)

Ryan, Gina J. PharmD, CDE*; Caudle, Jane M. MLn; Rhee, Mary K. MD; Hickman, Jamye M. PhD; Tsui, Circe W. MS; Barnes, Catherine S. PhD; Haomia, Jia PhD§; Ziemer, David C. MD, MPH

doi: 10.1097/PTS.0b013e31828bf5cb
Original Articles

Background: Medication history forms completed by patients are an essential part of the medication reconciliation process.

Objective: In a crossover prospective study, investigators compared the accuracy and acceptability of a “fill-in-the blank” medication history form (USUAL) to a customized form (CUSTOM) that contained a checklist of the 44 most frequently prescribed diabetes clinic medications.

Methods: The content of both forms was compared to a “gold-standard” medication list compiled by a clinical pharmacist who conducted a medication history and reviewed pharmacy profiles and medical chart. Subject preference and time to complete the forms were also determined. Accurate was defined as complete and correct (name, dose, and frequency) relative to the gold standard.

Results: A total of 77 subjects completed both forms. Complete list accuracy was poor; there was no difference in the accuracy between CUSTOM (6.5%) and USUAL (9.1%) (odds ratio [OR], 0.33; P = 0.62). Out of a total of 648 medications, subjects accurately listed 43.7% of medications on CUSTOM and 45.5% on USUAL (OR, 0.88; P = 0.41). The 44 medications on the checklist were more than twice as likely to be accurately reported using CUSTOM than with USUAL (OR, 2.1; P = 0.0002). More subjects preferred CUSTOM (65.7%) compared with USUAL (32.8%, P = 0.007).

Conclusion: Medication self-report is very poor, and few subjects created an accurate list on either form. Subjects were more likely to report the drugs on the checklist using CUSTOM than when they used USUAL; however, there was no difference in the overall accuracy between CUSTOM and USUAL.

*Department of Pharmacy Practice, Mercer University; †Department of Medicine, Division of Endocrinology and Metabolism, Emory University, Atlanta; ‡Social and International Studies, Southern Polytechnic University Marietta, Georgia; and §Department of Medicine, Division of Endocrinology and Metabolism, Columbia School of Nursing New York, New York, U.S.A.

Correspondence: Gina J. Ryan, PharmD, CDE, Department of Pharmacy Practice, DuVall 148, 3001 Mercer University, Atlanta, GA 30341 (e-mail: ryan_gj@mercer.edu).

Funding Source: This project was supported by grant number R21HS01823 from the Agency for Healthcare Research and Quality and is part of the Computer Assisted Medication Patient Interview Interface (CAMPII) project. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.

The authors disclose no conflict of interest.

© 2013 by Lippincott Williams & Wilkins