SOS Rx Coalition
Personal Medication Record Subcommittee Meeting
I. Introductions and Meeting Overview
The group agreed that the following statement would inform the day’s discussion:
Consumers should have a role in ensuring that a complete, accurate, and updated list of medications and supplements is available to all of their medical care providers so as to maximize therapeutic benefit and minimize the risk of adverse reactions.
II. Discussion of Existing PMR Efforts
Marc Boutin of the National Health Council indicated that the Council’s “Putting Patients First” educational campaign, which will launch in September, may be an opportunity to incorporate the SOS Rx Coalition’s efforts regarding the personal medication record because part of the campaign’s goal is to promote electronic medical records.
Francesca Cunningham of the Veterans Administration said the agency would soon enter phase two of its “My Health eVet” pilot project, which will provide an online prescription medication record for veterans.
Lygeia Ricciardi of the Markle Foundation explained that the
Connecting for Health program they are coordinating is addressing barriers to
electronic connectivity in the
Suzanne Mintz of the National Family Caregivers Association noted that November is National Family Caregivers month and is therefore a good time for public education efforts.
III. Broader issues that need to be addressed for this PMR project
The group identified the following issues for possible consideration in developing a PMR template. It was determined that, while many of these issues are important, they do not all need to be addressed specifically by the SOS Rx Coalition. These issues below were acknowledged as being part of the framework for current and future discussion.
Q Would it be appropriate to develop one or multiple template versions to account for factors such as patient age, gender, and number/severity of chronic conditions?
A All patients should note same information, so only one template is necessary; it was acknowledged that this template may need to be updated with varying frequency depending on certain factors (e.g., patient age, chronic conditions).
Ø Products with intermittent use need to be indicated (e.g., “When I have a headache, I take .)
Ø Need to keep pediatric patients in mind, especially with regard to dosage.
Q Is there a need to indicate the source of medication purchase (e.g., pharmacy or online)? Is there a need to indicate whether a medication was obtained as a sample?
A This issue was discussed, but it was determined that source is not a critical element for the PMR as it is not a strong risk factor for medication errors/events.
Q Given the need to target those with higher risk of interactions (at least initially), what particular data points are critical risk factors?
A Although we need to focus on constants that apply to everyone, primary risk factors are 1) use of numerous medications (five medications or more), 2) number of prescribing physicians, and 3) patient age.
Other Miscellaneous Points:
Ø Times of updating PMR must be clear.
Ø Need to know which doctor prescribed it? Contact information key.
Ø Primary uses of PMR: convey information to doctor, medication management, patient empowerment
Ø Public education regarding PMR should engage all stakeholders, but target doctors, LPNs, pharmacists, pharmacy clerks
1. Demographic Data
Ø Patient name
Ø Multiple phone numbers (e.g., cell, work, home)
Ø Birth date
Ø Names and phone numbers of all prescribing providers (indicate specialty)
Ø Emergency contact name and number
2. Experience Data
Ø Current chronic conditions/associated indications for medications
3. Medication Data
Ø Current prescription medications
Ø Current OTC medications
Ø Current vitamins, herbals, or other supplements
Ø Allergies (foods, medications)/ intolerances/bad reactions
Ø Indicate regular versus intermittent use (check box)
Ø Note in instructions to list all drugs including samples, patches, liquid formulas, etc…
4. Level of detail for prescription medications
Ø Dose strength (e.g. 20 mg)
Ø Dose frequency (e.g., once a day)
Ø Start date (and stop date?)
Ø Check off field to indicate last update by patient
Ø Direct patient to have provider review record (but no sign off by provider)
Ø Legal disclaimer re: provider review?
(Note: prescribers and indications already included in points 2 and 3)
5. Level of detail for OTC medications
Ø Same as for prescription medications
6. Template layout
Ø Patient ownership of information is key
Ø Pharmacist role in maintaining accuracy is key
Ø Focus group test – different people may need different formats
Ø Purpose: ease of portability
Ø Need for accuracy, updated information, portability
7. Patient/Physician review and update of PMR
Ø At least twice a year
Ø When starting a new medication
Ø When stopping a medication
Ø When there is a change of dose in medication
Ø Physician review - at every visit
V. Next Steps
Report at June 30th coalition meeting
Will review broader issues
Draft template PMR and circulate to this group for feedback and approval
Coalition approval of PMR
Dissemination - Follow up with other initiatives on how to integrate the PMR with other efforts, AHRQ small conference grant?