Evaluation of the accuracy of the Saskatchewan Health Pharmaceutical Information Program for determining a patient's medication use immediately before admission

Abstract

Background: The Pharmaceutical Information Program (PIP) administered by Saskatchewan Health provides records for individual patients of prescription medications and some over-the-counter products obtained with a prescription and processed through the provincial drug plan. Use of the PIP to assist in obtaining a medication history on admission to hospital has been advocated; however, the accuracy of the database has never been investigated. Objective: To quantify the extent of agreement between a patient's PIP profile and a Best Possible Medication History (BPMH) for determining the patient's prescription medication use on admission to hospital. Methods: General medicine patients admitted to 1 of the 2 clinical teaching units at the authors' hospital were reviewed for eligibility. A copy of the patient's PIP profile was printed, reviewed, and used in the course of obtaining a BPMH from consenting patients. The number and type of medication discrepancies and the time required to complete medication histories were documented. Results: Fifty patients were interviewed. For 39 patients (78%), one or more prescription discrepancies were identified between the PIP profile and the BPMH (mean 2.0, standard deviation 2.3, range 0-6). The top 3 prescription discrepancies were medication incorrectly appeared inactive in the PIP profile (49/101 discrepancies [49%]), dosing discrepancy (28/ 101 [28%]), and medication did not appear in the PIP profile (13/101 [13%]). The most common reasons for prescription discrepancies were recent change in dosage or medication (18 [18%]), compliance packaging (13 [13%]), noncompliance (12 [12%]), and entry error at the dispensing pharmacy (12 [12%]). Mean total time to prepare for and conduct interviews was 22.5 min (range 10-54 min). Conclusion: A patient's PIP profile may contain incomplete, inaccurate, or misleading information. Although the profile may be used to prompt the health care provider during a BPMH interview, it should never be used as a substitute for communicating directly with the patient.