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Competing Interests: Competing interests: None declared.

Competing Interests: Declaration of Conflicting Interests:Ms. Tri has nothing to disclose. Ms. Albers reports grants from Astra Zeneca, during the conduct of the tool development; personal fees from Astra Zeneca, outside the submitted work. Dr. Koshman has nothing to disclose. Dr. Bucci reports personal fees from Astra Zeneca, outside of the submitted work. Dr. Kertland reports personal fees from Astra Zeneca, outside the submitted work. Dr. Semchuk reports grants from Astra Zeneca, during the conduct of the study; personal fees from Astra Zeneca, outside the submitted work.

Background: Accurate and complete medication histories are not always obtained in clinical practice., Objective: This qualitative research study was undertaken to explore the barriers to and facilitators of obtaining accurate medication histories., Methods: Individual interviews, based on a structured interview guide, were conducted with 25 patients from both inpatient and ambulatory care clinic settings. Focus groups, based on a semistructured interview guide, were conducted with pharmacists, medical residents, and nurses. Transcribed data were analyzed by forming coded units and assessing these units for emerging themes., Results: Major themes that emerged from the patient interviews included patient ownership of health and medication knowledge (with knowledge of medications and their side effects and how to take medications being seen as important), patient-specific strategies to improve medication histories (e.g., use of regularly updated medication lists), and suggestions for system-level facilitators to improve medication histories (e.g., centralized databases of medication histories, increased patient education regarding the use and purpose of medications). Major themes also emerged from focus groups with health care professionals, including shared responsibility for medication history-taking among all 3 health care professions, perceptions about the barriers to medication history-taking (including patients not knowing their medications and not bringing their medication lists), and suggestions to improve medication histories (e.g., educating patients to bring medication vials to hospital admissions and appointments, using a centralized computer database for medication histories)., Conclusions: Key recommendations resulting from this study include using standardized documentation techniques for medication histories, recording of medication history information in centralized electronic databases, educating patients to bring medications to every health care visit, and establishing criteria for pharmacist referral for cases involving complex medication histories.

Non-ST segment elevation acute coronary syndromes (NSTE ACS) include a clinical spectrum that ranges from unstable angina to NSTE myocardial infarction. Management goals aim to prevent recurrent ACS and improve long-term outcomes by choosing a treatment strategy according to an estimate of the risk of an adverse outcome. Recent registry data suggest that patients with NSTE ACS frequently do not receive recommended treatment, and that risk stratification is not used to determine either the choice of treatment or the speed of access to coronary angiography. The present article evaluates the evidence for recommended treatment using information from recent trials and guidelines published by the major cardiac organizations in Europe and North America. Using this information, a multidisciplinary group developed a simplified algorithm that uses risk stratification to select an optimal early management strategy. Long-term outcomes are improved by a multi-faceted vascular protection strategy that is initiated at the time of hospitalization for NSTE ACS.

Hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitors, otherwise known as statins, are the most common class of lipid lowering medications prescribed today. Although this class of medications is contraindicated in pregnant women and those trying to conceive, there are many individuals who would benefit from these medications. Multiple randomized controlled trials have demonstrated that statins are effective in both primary and secondary prevention of coronary artery disease. Simple risk stratification tools can identify the women who would benefit.