This product is an ASHP Learning Center activity.

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.

This self-paced, online professional certificate is designed for pharmacist who are interested in expanding their knowledge and skills in medication history-taking and reconciliation.

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 Certificate 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.

Once a learner has completed the educational curriculum, they will have the opportunity to complete an online comprehensive final exam. Once the learner completes the final exam (minimum 80% passing rate; unlimited attempts permitted), they will earn the professional certificate.

Introduction to Medication History-Taking
ACPE: 0204-0000-23-763-H04-P
2.5 contact hours

Learning Objectives:

• Recognize the risks and consequences of errors in medication history-taking.
• Describe the results of past studies demonstrating the benefits of accurate medication history-taking.
• Summarize the barriers to accurate medication history-taking.
• Define key terms related to the medication reconciliation process.
• Describe each step of the medication reconciliation process.
• Identify the components of a "best possible" medication history (BPMH).
• Explain the importance of an accurate and comprehensive BPMH to providing 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 and reconciliation processes that must be answered prior to implementation of this service.

Medication Safety and Adherence
ACPE: 0204-0000-23-764-H05-P
3 contact hours

Learning Objectives:

• Explain the relationship between medication errors and adverse drug events.
• Describe reasons why medication errors occur during care transitions.
• Identify factors that contribute to medication discrepancies.
• Distinguish between medication discrepancies that occur secondary to medication history errors and those that occur due to reconciliation errors.
• Summarize patient factors that influence the ability to report medication regimen information accurately.
• Explain factors that impact medication adherence.
• Recommend strategies that may be utilized to improve medication adherence.
• 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 medications salt forms;
• 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: 0204-0000-23-765-H05-P
3.25 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 interpersonal and professional skills and behaviors necessary for medication history-takers.
• Explain interview skills utilized by effective medication history-takers.

Evaluating Medication History-Taking
ACPE: 0204-0000-23-766-H05-P
3.5 contact hours

Learning Objectives:

• Identify desired skills and behaviors of effective medication history-takers in preparation for evaluating medication history-taking scenarios.
• Evaluate medication history-taking scenarios to identify best practices, as well as areas for improvement.

Implementing a Medication History-Taking Service
ACPE: 0204-0000-23-767-H04-P
2.25 contact hours

Learning Objectives:

• Discuss aspects of a medication history program to be considered during the planning phase.
• Explain the keys to a successful medication history program.
• Explain aspects of a medication history program that require customization for each institution.

Medication Reconciliation
ACPE: 0204-0000-23-768-H05-P
2.5 contact hours

Learning Objectives:

• 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.
• 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.

Amanda S. Mixon, MD, MS, MSPH, FHM
Associate Professor of Medicine
Vanderbilt University Medical Center
Nashville, Tennessee

Jeffrey L. Schnipper, MD, MPH, MHM
Professor of Medicine
Brigham and Women's Hospital - Harvard Medical School
Boston, Massachusetts

DeeAnn Wedemeyer-Oleson, PharmD, MHA, CPHQ, CPPS
Director of Scientific Projects, Special Projects
ASHP
Bethesda, Maryland

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 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.

This online activity consists of a combined total of 6 learning modules. Pharmacists are eligible to receive a total of 17 hours of continuing education credit by completing all 6 modules within this professional certificate.

Participants must participate in the entire activity and complete the evaluation and all required components to claim continuing pharmacy education credit online at ASHP Learning Center. Follow the prompts to claim credit and view your statement of credit within 60 days of 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

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