Step 1: Best Possible Medication History (BPMH) includes ALL prescribed (based on the advice of prescriber) and non-prescribed medications (not based on prescriber’s advice)
Creation of the BPMH requires use of a systematic process for obtaining a medication history from multiple sources by:
Interviewing patients and/or family where possible.
Verifying and documenting the history and clarifying any conflicting information.
Other sources should never be a substitute for a thorough patient and/or family medication interview where it is possible.
Step 2: Verify and document the history with more than one source
Step 3: Admission medication reconciliation processes: proactive or retroactive
Step 4: At the end of the episode of care, the Best Possible Medication Discharge Plan (BPMDP) should be given to the patient and primary care physician or alternative care facility or health care team/service that will next be providing care to the patient.
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