The process of creating the most accurate list of a patient’s current medications and comparing them with the physician’s admission, transfer, and/or discharge orders, to avoid medication errors and adverse drug events.
Any injury resulting from the use of a medication. Adverse drug events may be preventable or non-preventable and can occur during any stage of medication use.
The movement of patients between healthcare practitioners, settings, or levels of care. Transitions of care include admissions, transfers, and discharges.
The concurrent use of multiple medications by a patient, typically five or more. Polypharmacy increases the risk of adverse drug events, drug interactions, and medication non-adherence.
A digital version of a patient’s paper chart, containing medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory test results.
A situation in which one substance alters the effect of another substance when both are administered together. Drug interactions can lead to decreased or increased drug effectiveness, toxicity, or unexpected side effects.
The extent to which patients take medications as prescribed by their healthcare providers. Poor medication adherence can lead to treatment failure, worsening of disease, and increased healthcare costs.
A comprehensive record of a patient’s current and past medication use, including prescription medications, over-the-counter drugs, dietary supplements, and herbal products.
Any difference between the medication regimen documented in the patient’s medical record and the medications the patient reports taking. Medication discrepancies can result from errors in documentation, communication, or prescribing.
The prevention of medication errors and adverse drug events to ensure that patients receive the correct medications in appropriate doses, routes, and frequencies, while minimizing risks and maximizing benefits.