OBJECTIVE: To determine at admission the number of discrepancies in medication use, comparing the structured history of medication use (SHIM) procedure with the usual procedure for taking the medication history in a clinical setting. DESIGN AND METHODS: A prospective observational study was conducted at the inpatient old age psychiatric clinic of a psychiatric teaching hospital in The Hague, The Netherlands, and at the geriatric ward of the University Medical Center Utrecht, The Netherlands. For every patient, the medication history taking at admission by the treating physician was followed by and compared with the SHIM procedure administered by the researcher. The SHIM procedure consists of a structured interview with the patient about the actual use of medication, incorporating the information from the community pharmacy and the patient's medications brought to the interview. The main outcome was the number of discrepancies in recorded medication use between the SHIM and the usual procedure. Secondary outcome measures were potential clinical relevance and actual clinical consequences. RESULTS: 100 (UMC Utrecht) and 50 (The Hague) patients were included. Their mean age was 82 years (UMC Utrecht) and 69 years (The Hague). Discrepancies were found in 92% (UMC Utrecht) and 78% (The Hague) of the patients. 72% (UMC Utrecht) and 82% (The Hague) of all discrepancies were potentially clinically relevant. Clinical consequences occurred in 21% (UMC Utrecht) and 24% (The Hague) of the patients. CONCLUSION: The SHIM procedure enables an accurate overview of the medication used by elderly patients, and contributes to the prevention of clinically relevant adverse drug events.
|Number of pages||5|
|Publication status||Published - 20 Jun 2014|