Washington, DC — Medication histories recorded for trauma patients in a rural population were highly inaccurate and incomplete due to communication problems among hospital personnel and difficulties in obtaining complete medical histories from patients who have trouble speaking or remembering exactly what medications they take.  The study of 234 patients is published online today in the Annals of Emergency Medicine (“Medication Reconciliation in a Rural Trauma Population”).

“Medication errors are generally the result of system breakdown, and trauma patients are particularly vulnerable because the need for speed when treating them may make obtaining a complete medical history impossible,” said lead study author S. Lee Miller, MD, of the Conemaugh Memorial Medical Center in Johnstown, Pa.  “This study raises questions about how medical care providers can develop better methods for gathering a complete medical history, including medications, food supplements and over-the-counter drugs.  Fortunately, in our patient group, there was only one adverse drug event, and that patient recovered, but that is still one event too many.”

Researchers studied 234 trauma patients in a rural setting, the majority of whom were moderately injured.  Medication lists given upon admission to the hospital were inaccurate 85 percent of the time.  Ten patients were ordered wrong medications and one adverse drug event (hypoglycemia) occurred.  Some of the reasons that medication lists were incomplete included poorly informed or forgetful patients or accompanying family members, patients taking medications from pharmacies who would not divulge patient information, and patients with multiple doctors outside the hospital who did not know what the others were prescribing.

“Across health care, medicine-related errors are the costliest ‘disease’ in America, principally because we have no good system for recording all of a patient’s medications,” said Dr. Miller.  “Until we have an accurate and secure electronic medical records system, people can help themselves three ways: Carry with you at all times a complete list of all medications, including over-the-counter drugs, as well as your pharmacist’s contact information; have a single pharmacist who knows all medications you are currently taking; and if you see multiple physicians, make sure they all know all medications you are taking, and designate one – probably your primary care physician – who will keep your complete medical record.”

The American College of Emergency Physicians supports the implementation of electronic medical records and is committed to the development of an interoperable nationwide health information network linking all components of the health care system.  In the meantime, for a form on which to record a medical history to carry with you, go to: http://www.emergencycareforyou.org/WorkArea/DownloadAsset.aspx?id=672.

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society with more than 25,000 members. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.

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