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Medication historians help prevent adverse drug interactions
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Medication historians help prevent adverse drug interactions

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SIOUX CITY | Being a medication historian is more of an art than a science.

Martin Cortez and Andrew Welding interview patients who are admitted to UnityPoint Health-St. Luke's about the medications they're taking, which can range from a couple of prescription drugs to more than a dozen.

"We try to figure out what they're all taking for medications currently and get that up-to-date for the hospitalists, the nurses and everybody else here," Welding explained.

The process seems simple, but Cortez said it's not. Patients often don't know the names of these drugs, nor do their family members. Cortez and Welding make multiple calls to primary care providers, specialists and pharmacies in order to compile an accurate list.

"So many medications out there have different formulations, but they're all under the same name," Cortez said. "If a patient tells you the name of a medication, then you have to decipher, 'Which form are you on?' Most patients don't really know which one they're on."

St. Luke's has employed medication historians since November 2014. Before then, Mike Padomek, St. Luke's director of pharmacy, said nurses typically gathered medication histories. He said patients struggle listing their medications and often say things like, "Oh, it's the little white pill or the little green one."

"We thought it might be helpful to have an expert that did nothing but this," he said. "If we don't document that they're on the right medicine, sometimes a medicine can actually lead to an admission. We want to know what medicines may have caused that admission."

Adverse drug interactions occur when a drug interferes with another drug. Prescription drugs, over-the-counter medications and vitamins can be involved. Some common symptoms of drug interactions include nausea, headache, heartburn and lightheadedness.

"If you take one medicine it might make you sleepy. If you take another medicine with it, you can get double sleepy -- that's probably the most common side effect that I always think about," Padomek said. "Depending on the drug and interactions, almost anything can happen."

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The Health and Medicine Division of the National Academies of Sciences, Engineering and Medicine says medication errors are among the most common medical errors, harming at least 1.5 million people every year.

Studies show that 400,000 preventable drug-related injuries occur each year in hospitals. Another 800,000 occur in long-term care settings, while 530,000 occur among Medicare recipients in outpatient clinics.

Annually, $3.5 billion alone is spent treating drug-related injuries that occur in hospitals. That estimate doesn't include lost wages and productivity or additional health care costs.

Cortez and Welding are licensed pharmacy technicians. They've done a lot of on-the-job training at St. Luke's working alongside hospital pharmacists to become medication experts.

"It's asking the right questions and knowing where to look -- that really comes with time and experience," said St. Luke's pharmacist Lesleigh Ailts. "The next time you run into a patient with the same sort of issue, you know exactly how to approach it."

Although patients were apprehensive when Cortez and Welding first started coming to their hospital rooms with paper charts in hand to talk to them, they've gotten used to it and some even remember the medication historians from previous admissions.

Compiling a medication history usually takes anywhere from half an hour to an hour. If the patient is unconscious or has a lengthy medical history, Cortez said it can take much longer.

"Being in a tri-state area, we get a lot of truckers as well who get admitted and they tend to use pharmacies all over the country," he said. "Trying to figure out what they're on by calling the pharmacy can be quite difficult, luckily a lot of the retail pharmacies now have a connected network system."

Welding said patients should carry an up-to-date, accurate list of medications with them or bring along their pill bottles. Cortez added that patients should understand their medications and how they work.

"Patients shouldn't be apprehensive about asking their community pharmacist, 'What does this medicine do? Does it interact with anything?'" he said. "Being an advocate for their care is the biggest thing."

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