Question

Why medications, vitamins and herbal supplements taken are important to include in the health history of the patient?
150 words, please cite the reference.

Answer 1

Use of over the counter drugs, herbal and dietary / vitamin supplements with or without prescription is very common but least reported component in medication and health history of patients.

Most of times people use such products based on previous experiences, suggestions from friends or family and under the influence of advertisements. However often they do not pay attention to indications or active ingredients, do not adhere to maximum daily dose or duration of use, rarely read warnings of unintentional overdose. Simultaneously intake many products with the same active ingredients (ex as in case of acetaminophen) may result in overdose and toxicity.

These challenges are further compounded by low health literacy because it interferes with person’s choice to seek out professional advice and communicate this important health information.

Accurate documentation of use of herbal, dietary or alternative therapies or use of multiple drugs is very significant as:

· Many products can mask clinical signs or alter results of investigations. For example, corticosteroids can prevent abdominal pain and rigidity in a patient with a perforated duodenal ulcer, use of Amiodarone can alter results of thyroid function tests.

· Poor reporting may result in preventable errors in prescribing medication, as it may lead to unwanted duplication of drugs, drug interactions and abrupt discontinuation of long-term medications resulting in withdrawal symptoms. Drug interaction can enhance or suppress the effect of other drugs leading to symptoms of overdose which can be fatal or inability to produce desired effect.

· History about use of such products also provides an opportunity to health care providers to educate the patient about safety while using these products, minimise potential drug interactions and unintentional misuse.

· Knowledge of the drugs/ herbal or vitamin supplements a patient has taken in the past or is currently taking will help in identifying allergic or hypersensitivity reaction and in planning future treatment.

Therefore a good medication history should encompass all currently and recently prescribed drugs, previous adverse drug reactions including hypersensitivity reactions, any over-the counter medications, including herbal, dietary, vitamin supplements or alternative medicines, and adherence to therapy.

Reference:

FitzGerald, J. (2009). Medication errors: the importance of an accurate drug history. British Journal of Clinical Pharmacology, 67(6), 671-675.doi:10.1111/j.1365-2125.2009.03424.x

Potter. Parry’s. (2012) Fundamentals of nursing. 4 edition. Australia: Mosby imprints