Patient data records, drug history

The medical record is another source of medication and health-related information. Access to this record may be limited in certain practice settings however, it can be a valuable tool to review prior to conducting your patient drug history interview. Some practitioners use medical release forms to obtain medical record information such as laboratory data from other institutions required for drug therapy monitoring. 

Modern technology should help. For example, pharmacists are developing databases that help them to identify drug interactions. In the future, the medical history of a patient could be added to a card which could be used by a pharmacist to ensure that the patient s prescribed medicine is appropriate. It would also be possible to input safety data on drugs to computer systems already used by prescribing physicians to store their patients records. The physician would then be alerted to any contraindications, warnings or precautions that may be relevant to individual patients if prescribed the drug. 

The above study was based on information derived from the General Practice Research Database in the UK. Subjects who had been given at least one prescription for dexfenfluramine, fenfluramine, or phentermine after 1 January 1988, and who were 70 years or younger at the time of their first prescription were included. Subjects were considered to have a new cardiac abnormality if they had no history, on the basis of clinical records, of cardiac valvular abnormahties and if there was evidence of a new valvular disorder on the basis of echocardiography or chnical examination after exposure to appetite suppressants. All the data had been recorded before the pubhcation of recent reports of an association between appetite suppressants and cardiac valve disorders (25,27,30-32) or primary pulmonary hjq)ertension (14). Hence, it was possible to exclude the possibihty that enhanced awareness of possible serious adverse effects of appetite suppressants had led to closer surveillance of patients who were taking these drugs. Nevertheless, the study did not provide information on the frequency of idiopathic cardiac valve disorders that are asymptomatic or otherwise not chnicaUy diagnosed. 

Access to a patient s medical records is essential to the provision of collaborative drug therapy management. In fact, it is only under these conditions, wherein the phamiacist has adequate knowledge of the patient and the patient s history, disease states, drug therapy, and laboratory and procedure results, that quality care can be rendered. Much work is being done in this area, via computerization of medical records and network facilitation of electronic data, to ensure this key element is in place to facilitate patient care by health care providers. 

The project director at each site interviewed each patient to explain the nature of the experiment and to obtain informed consent. A project social worker gathered data on SES nutritional habits alcohol consumption, smoking and drug habits history of past pregnancies and so on. Additional information was obtained from hospital records. 

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