Medication discrepancies occur most often at transitions in care - admission, transfer and discharge
Medication discrepancies are common and can cause adverse events
Approximately 50% of patients will have at least one discrepancy between home meds and meds ordered in hospital
At least one third of discrepancies have the potential to be clinically important resulting in harm
All of the above
True
False
Vitamins
Over-the-counter medications
Herbal products
Prescription medications
Interview the patient and/or caregiver
List all the medications the patient is taking at home from their original containers and how they are actually taken
Review at least one other reliable source of information (ex. community pharmacy, MOHLTC database, previous health record in Sunnycare)
Consult a Pharmacist
True
False
True
False
Home medications which are to be continued
Home medications which are changed
Home medications which are stopped
New medications to be taken
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