MARQUIS Best Possible Medication History (BPMH) Quick Tips MARQUIS Best Possible Medication History (BPMH) Quick
ication History (BPMH) Quick Tips
Goal → Obtain complete information on the patient’s medication regimen, Goal → Obtain complete information on the patient’s medication regimen,
including: including:
o Name of each medication o Name of each medication
o Formulation (e.g., extended release) o Formulation (e.g., extended release)
o Dosage, Route, Frequency o Dosage, Route, Frequency
o Non-prescription medications (e.g., herbals, OTCs, vitamins) o Non-prescription medications (e.g., herbals, OTCs, vitamins)
Try to use at least two sources of information and explore discrepancies Try to use at least two sources of information and explore discrepancies between
between the different sources the different sources
If your starting point is a medication list: If your starting point is a medication list:
o Review and verify each medication with the patient. o Review and verify each medication with the patient.
o Best to start by having the patient tell you what he or she is taking; o Best to start by having the patient tell you what he or she is taking;
don’t read the list aloud asking if it is correct don’t read the list aloud asking if it is correct
Questions to elicit a complete medication list: Questions to elicit a complete medication list:
o For each medication, elicit the dose and time(s) of day taken. o For each medication, elicit the dose and time(s) of day taken.
o When appropriate, ask about formulation and route of administration. o When appropriate, ask about formulation and route of administration.
o Start with an open-ended question: What medications do you take at o Start with an open-ended question: What medications do you take at
home? home?
o Use Probing Questions (on the back) to minimize missed medications o Use Probing Questions (on the back) to minimize missed medications
Time-saving tips: Time-saving tips:
Start with easily accessible sources (e.g., outpatient EMR med list, Start with easily accessible sources (e.g., outpatient EMR med list,
recent hospital discharge orders) recent hospital discharge orders)
If patients use a list or pill bottles and seem completely reliable (and If patients use a list or pill bottles and seem completely reliable (and
data are not that dissimilar from the other sources, and/or the data are not that dissimilar from the other sources, and/or the
differences can be explained), then other sources not needed. differences can be explained), then other sources not needed.
If patients are not sure, relying on memory only, or cannot clearly If patients are not sure, relying on memory only, or cannot clearly
“clean up” the other sources of medication information, then use “clean up” the other sources of medication information, then use
additional sources such as community pharmacy data. additional sources such as community pharmacy data.
If the medication history is still not clear (e.g., suspected differences If the medication history is still not clear (e.g., suspected differences
between what the patient is supposed to be taking and what they between what the patient is supposed to be taking and what they
actually take) then contact outpatient physician office(s) and/or have actually take) then contact outpatient physician office(s) and/or have
the family bring in the pill bottles from home. Page 1 the family bring in the pill bottles from home. Page 1
MARQUIS Best Possible Medication History (BPMH) Quick Tips MARQUIS Best Possible Medication History (BPMH) Quick Tips
Goal → Obtain complete information on the patient’s medication regimen, Goal → Obtain complete information on the patient’s medication regimen,
including: including:
o Name of each medication o Name of each medication
o Formulation (e.g., extended release) o Formulation (e.g., extended release)
o Dosage, Route, Frequency o Dosage, Route, Frequency
o Non-prescription medications (e.g., herbals, OTCs, vitamins) o Non-prescription medications (e.g., herbals, OTCs, vitamins)
Try to use at least two sources of information and explore discrepancies Try to use at least two sources of information and explore discrepancies between
between the different sources the different sources
If your starting point is a medication list: If your starting point is a medication list:
o Review and verify each medication with the patient. o Review and verify each medication with the patient.
o Best to start by having the patient tell you what he or she is taking; o Best to start by having the patient tell you what he or she is taking;
don’t read the list aloud asking if it is correct don’t read the list aloud asking if it is correct
Questions to elicit a complete medication list: Questions to elicit a complete medication list:
o For each medication, elicit the dose and time(s) of day taken. o For each medication, elicit the dose and time(s) of day taken.
o When appropriate, ask about formulation and route of administration. o When appropriate, ask about formulation and route of administration.
o Start with an open-ended question: What medications do you take at o Start with an open-ended question: What medications do you take at
home? home?
o Use Probing Questions (on the back) to minimize missed medications o Use Probing Questions (on the back) to minimize missed medications
Time-saving tips: Time-saving tips:
Start with easily accessible sources (e.g., outpatient EMR med list, Start with easily accessible sources (e.g., outpatient EMR med list,
recent hospital discharge orders) recent hospital discharge orders)
If patients use a list or pill bottles and seem completely reliable (and If patients use a list or pill bottles and seem completely reliable (and
data are not that dissimilar from the other sources, and/or the data are not that dissimilar from the other sources, and/or the
differences can be explained), then other sources not needed. differences can be explained), then other sources not needed.
If patients are not sure, relying on memory only, or cannot clearly If patients are not sure, relying on memory only, or cannot clearly
“clean up” the other sources of medication information, then use “clean up” the other sources of medication information, then use
additional sources such as community pharmacy data. additional sources such as community pharmacy data.
If the medication history is still not clear (e.g., suspected differences If the medication history is still not clear (e.g., suspected differences
between what the patient is supposed to be taking and what they between what the patient is supposed to be taking and what they
actually take) then contact outpatient physician office(s) and/or have actually take) then contact outpatient physician office(s) and/or have
the family bring in the pill bottles from home. Page 1 the family bring in the pill bottles from home. Page 1
Probing Questions: Probing Questions:
Ask about scheduled medications. Ask about scheduled medications.
Ask about PRN medications. Ask about PRN medications.
o Which medicines do you take only sometimes? o Which medicines do you take only sometimes?
o What symptoms prompt you to take them? o What symptoms prompt you to take them?
o How many doses per week do you take? o How many doses per week do you take?
o What’s the most often you are allowed to take it? o What’s the most often you are allowed to take it?
o Do you often take something for headaches? Allergies? To help you o Do you often take something for headaches? Allergies? To help you fall
fall asleep? When you get a cold? For heartburn? For constipation? asleep? When you get a cold? For heartburn? For constipation?
Assessing the purpose of each medication may lead to additional prompts. Assessing the purpose of each medication may lead to additional prompts.
o What is each medicine for? o What is each medicine for?
o Do you take any other medications for that? o Do you take any other medications for that?
Ask about medications for specific conditions that the patient has. Ask about medications for specific conditions that the patient has.
o What medicines do you take for your diabetes, high blood pressure, o What medicines do you take for your diabetes, high blood pressure,
etc.? etc.?
Ask about medications prescribed by subspecialists who follow the patient. Ask about medications prescribed by subspecialists who follow the patient.
o Does your [arthritis doctor] prescribe any medications for you? o Does your [arthritis doctor] prescribe any medications for you?
Ask about medications that are easy to forget. Ask about medications that are easy to forget.
o Do you take any inhalers, nebulizers, nasal sprays, ointments, creams, o Do you take any inhalers, nebulizers, nasal sprays, ointments, creams,
eye drops, ear drops, patches, injections or suppositories? eye drops, ear drops, patches, injections or suppositories?
o Do you take any medications in the evening or at night? o Do you take any medications in the evening or at night?
o Do you take any medicines once a week or once a month? o Do you take any medicines once a week or once a month?
Ask about non-prescription products. Ask about non-prescription products.
o Which medicines do you take that don’t require a prescription? (Over- o Which medicines do you take that don’t require a prescription? (Over-
the-counter medicines, vitamins, herbals and minerals.) the-counter medicines, vitamins, herbals and minerals.)
Assess recent medication use and adherence. Assess recent medication use and adherence.
o When did you take the last dose of each of your medicines? o When did you take the last dose of each of your medicines?
o Tell me about any problems that you’ve had taking these medicines as o Tell me about any problems that you’ve had taking these medicines as
prescribed. prescribed.
o Many patients have difficulty taking their medications exactly as they o Many patients have difficulty taking their medications exactly as they
should every day. In the last week, how many days have you missed a should every day. In the last week, how many days have you missed a
dose of your [medication]? dose of your [medication]?
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Probing Questions: Probing Questions:
Ask about scheduled medications. Ask about scheduled medications.
Ask about PRN medications. Ask about PRN medications.
o Which medicines do you take only sometimes? o Which medicines do you take only sometimes?
o What symptoms prompt you to take them? o What symptoms prompt you to take them?
o How many doses per week do you take? o How many doses per week do you take?
o What’s the most often you are allowed to take it? o What’s the most often you are allowed to take it?
o Do you often take something for headaches? Allergies? To help you o Do you often take something for headaches? Allergies? To help you fall
fall asleep? When you get a cold? For heartburn? For constipation? asleep? When you get a cold? For heartburn? For constipation?
Assessing the purpose of each medication may lead to additional prompts. Assessing the purpose of each medication may lead to additional prompts.
o What is each medicine for? o What is each medicine for?
o Do you take any other medications for that? o Do you take any other medications for that?
Ask about medications for specific conditions that the patient has. Ask about medications for specific conditions that the patient has.
o What medicines do you take for your diabetes, high blood pressure, o What medicines do you take for your diabetes, high blood pressure,
etc.? etc.?
Ask about medications prescribed by subspecialists who follow the patient. Ask about medications prescribed by subspecialists who follow the patient.
o Does your [arthritis doctor] prescribe any medications for you? o Does your [arthritis doctor] prescribe any medications for you?
Ask about medications that are easy to forget. Ask about medications that are easy to forget.
o Do you take any inhalers, nebulizers, nasal sprays, ointments, creams, o Do you take any inhalers, nebulizers, nasal sprays, ointments, creams,
eye drops, ear drops, patches, injections or suppositories? eye drops, ear drops, patches, injections or suppositories?
o Do you take any medications in the evening or at night? o Do you take any medications in the evening or at night?
o Do you take any medicines once a week or once a month? o Do you take any medicines once a week or once a month?
Ask about non-prescription products. Ask about non-prescription products.
o Which medicines do you take that don’t require a prescription? (Over- o Which medicines do you take that don’t require a prescription? (Over-
the-counter medicines, vitamins, herbals and minerals.) the-counter medicines, vitamins, herbals and minerals.)
Assess recent medication use and adherence. Assess recent medication use and adherence.
o When did you take the last dose of each of your medicines? o When did you take the last dose of each of your medicines?
o Tell me about any problems that you’ve had taking these medicines as o Tell me about any problems that you’ve had taking these medicines as
prescribed. prescribed.
o Many patients have difficulty taking their medications exactly as they o Many patients have difficulty taking their medications exactly as they
should every day. In the last week, how many days have you missed a should every day. In the last week, how many days have you missed a
dose of your [medication]? dose of your [medication]?
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