This product is an ASHP Learning Center https://elearning.ashp.org/ activity.
Accreditation
The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education with Commendation.
Target Audience
This training program is intended for pharmacists who are interested in expanding their knowledge and skills in medication history-taking and reconciliation.
Overview
The processes of obtaining comprehensive and accurate medication histories, and reconciling medications across the care continuum, are of critical importance to protecting patients from medication errors. The Medication History-Taking and Reconciliation Training Program is designed to equip pharmacists and student pharmacists to directly participate in, and provide oversight of, these essential clinical pharmacy services.
The curriculum includes the following topics:
- The impact of incomplete and inaccurate medication histories on patient safety;
- sources of information for medication histories;
- interviewing patients to gather “best possible” medication histories;
- recommendations for avoiding common errors and omissions when obtaining medication histories;
- medication adherence assessment and improvement strategies;
- standardized approach to medication reconciliation at transitions in care;
- legal considerations related to medication history-taking; and
- customizing and implementing a medication history-taking service.
Medication History-Taking & Reconciliation Training Program Requirement
Once a learner has completed the educational curriculum, they will have the opportunity to complete an online comprehensive exam. Once the learner passes the exam (minimum 80% passing rate; unlimited attempts permitted), they will earn the statement of completion for the training program.
Educational Activities
Establishing a Medication History-Taking Service
ACPE: 0204-0000-26-704-H04-P
Application-based
2.25 contact hours
Learning Objectives:
- Explain terms related to medication history-taking and reconciliation.
- Summarize the relationship between accurate medication histories and safe patient care.
- Apply the Health Insurance Portability and Accountability Act (HIPAA) law regarding patient confidentiality to the medication history-taking process.
- Identify legal questions applicable to those involved in medication history-taking that must be answered and addressed prior to implementation of this service.
- Describe challenges associated with a medication history-taking program that should be considered during the planning phase.
- Explain the decisions related to implementation of a medication history-taking program that must be made during the planning phase.
- Identify key attributes of successful medication history-taking programs.
- Give examples of data measures that could be tracked to monitor the quality of a medication history-taking program.
Medication Safety and Adherence
ACPE: 0204-0000-26-705-H05-P
Application-based
2.75 contact hours
Learning Objectives:
- Describe factors that contribute to the following:
- Adverse drug events during care transitions, particularly post-discharge
- Medication discrepancies
- Patients' difficulties reporting complete and accurate information about their medication regimen
- Identify medication discrepancies that occur secondary to medication history errors and those that occur due to reconciliation errors.
- Explain the types of, and factors contributing to, medication non-adherence.
- Describe various medication adherence aids.
- Recommend strategies for identifying medication non-adherence during medication history-taking, including techniques for questioning patients about adherence and identifying clues from medication adherence aids.
- Discuss the process for accurately identifying patients.
- Apply best practices for safe communication of medication information.
- Explain the potential for medication errors associated with the following: Incorrect conversion between micrograms and milligrams; liquid medication concentrations; combination medications and strengths; multiple salt forms of the same base drug; mineral salt form vs. elemental strengths; extended-release formulations; over-the-counter brand name extensions; and risk of repeated medication doses at admission.
- Describe methods for prioritizing medication history-taking based on patients at high risk of medication errors.
Best Possible Medication History-Taking
ACPE: 0204-0000-26-706-H05-P
Application-based
2.5 contact hours
Learning Objectives:
- Explain the goals of obtaining an accurate and comprehensive medication history.
- Identify the essential components of a medication history.
- Identify sources of information about patients’ medication regimens that can be utilized when obtaining medication histories.
- Explain the advantages and limitations of different sources of medication regimen information.
- Explain the process of obtaining home medication information, comparing information from multiple sources to identify discrepancies, and resolving discrepancies.
- Give examples of interview questions that increase the likelihood of obtaining complete and accurate home medication information.
- Identify components of medication history documentation.
- Describe communication skills utilized by effective medication history-takers.
- Apply strategies to overcome communication barriers during a medication history interview.
- Describe attitudes and professional behaviors of effective medication history-takers.
Medication Reconciliation
ACPE: 0204-0000-26-707-H04-P
Application-based
2.75 contact hours
Learning Objectives:
- Describe strategies for successful implementation of a pharmacist medication reconciliation program.
- Explain the resources necessary for implementation of a pharmacist medication reconciliation program.
- Explain the clinical decision-making questions related to ordering home medications at admission, and when performing medication reconciliation during transfers and at discharge.
- Explain the fundamental processes of a pharmacist-driven “home medications per pharmacy” service.
- Analyze data from a prospective study about pharmacist-driven medication ordering under a collaborative practice arrangement.
- Compare a prescriber-oriented ordering model with a pharmacist-driven ordering model.
Faculty Information
Laura Beres, PharmD, BCACP
Pharmacy Program Coordinator – Transitions of Care
Advocate Aurora Health Care
Milwaukee, Wisconsin
DeeAnn Wedemeyer-Oleson, PharmD, MHA, BCGP, CPHQ, CPPS
Director, Scientific Projects, Special Projects
American Society of Health-System Pharmacists
Bethesda, Maryland
Relevant Financial Relationship Disclosure
In accordance with our accreditor’s Standards of Integrity and Independence in Accredited Continuing Education, ASHP requires that all individuals in control of content disclose all financial relationships with ineligible companies. An individual has a relevant financial relationship if they have had a financial relationship with an ineligible company in any dollar amount in the past 24 months and the educational content that the individual controls is related to the business lines or products of the ineligible company.
An ineligible company is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The presence or absence of relevant financial relationships will be disclosed to the activity audience.
- No one in control of the content of this activity has a relevant financial relationship (RFR) with an ineligible company.
As defined by the Standards of Integrity and Independence in Accredited Continuing Education definition of ineligible company.
Methods and CE Requirements
Each activity consists of audio, video, and/or PDFs and evaluations. Learners must review all content and complete the evaluations to receive continuing pharmacy education credit for each activity.
Follow the prompts to claim, view, or print the statement of credit within 60 days after completing the activity.
Important Note – ACPE 60 Day Deadline:
Per ACPE requirements, CPE credit must be claimed within 60 days of being earned. To verify that you have completed the required steps and to ensure your credits have been reported to CPE Monitor, check your NABP eProfile account to validate that your credits were transferred successfully before the ACPE 60-day deadline. After the 60-day deadline, ASHP will no longer be able to award credit for this activity.
System Technical Requirements
ASHP learning content is delivered through your Web browser. For all learning content, you will need basic computer skills, the ability to navigate web pages and stable internet connection. View the system requirements for learning activities.