Accuracy of the medication history at admission to hospital in Saudi Arabia

Objective: Inaccurate medication history at admission to hospitals leads to preventable adverse drug events, which in turn increase mortality, morbidity, and health care costs. The objec- tive of this study was to investigate the role of pharmacists in identifying discrepancies in medica- tion histories at admission to a tertiary referral hospital in Saudi Arabia. Methods: We performed a prospective observational study in a 1200 bed tertiary hospital in Riyadh, Saudi Arabia. Patients were included if they were aged 16 years or older, were taking 5 or more medications, and were able to communicate or were accompanied by a caregiver who could communicate. Over 2 months in 2009, a pharmacist interviewed patients to ascertain all medications used prior to hospitalization, then all discrepancies were discussed with the admitting physician and unintended discrepancies were reported as errors. Results: A pharmacist interviewed 60 patients who were taking 564 medications total. Of these patients, 65% were male, and their mean age was 62. Patients were taking an average of 9.4 medications. Twenty-two (37%) patients had at least one discrepancy, with the most common being omissions of medications (35%) and dosage errors (35%). The mean age for patients with discrep- ancies was 64.6 years, and without discrepancies, 60.8 years (P = 0.37). Conclusion: Inaccurate medication history at admission to a hospital was common in Saudi Ara- bia. This has the potential to cause harm to patients if it remains undetected. Pharmacists could potentially play a major role in obtaining this medication history at the time of hospital admission.