Chapter 2: Assessment of Current Medication Management

INTRODUCTION Assessment of a patient’s current medication management is vital to ensure the quality use of medicines. The assessment aims to optimise the quality use of medicines and therefore patient outcomes, and to minimise medicines-related problems. To assess the patient’s current medication management, the pharmacist confi rms the safety and appropriateness of individual medication orders and the combination of medicines prescribed. This assessment is then documented in the patient’s record or the pharmacy section of the National Inpatient Medication Chart (NIMC) or equivalent. Assessment of a patient’s current medication management should not be done in isolation. It requires a systematic, in-depth assessment of current medicines in consultation with the patient taking into account: • the patient’s medication history • the patient’s medication management plan (MMP) and data from the medication administration record • a clinical review including therapeutic drug monitoring (TDM).