Aim: To evaluate whether medication history-taking via telephone interview is an alternative to face-to-face medication history-taking in elective surgical patients planned for admission after surgery. Method: Patients undergoing elective surgery who were planned for post-procedure admission during an 8-week period between February and March 2015 were eligible for enrolment. A semi-structured, scripted medication history interview was performed via telephone on the working day prior to the booked admission date for patients who met the inclusion criteria. Blinded comparator face-to-face histories were documented post-operatively as per standard practice. Discrepancies identified were risk stratified via consensus by a panel of three pharmacists. Results: Sixty-four patients received a telephone history interview and comparator face-to-face interview. The average number of medications was 4.47 for phone history versus 4.64 for face-to-face interview (p = 0.247). The average time to conduct a phone history interview was 5.8 min (standard deviation 3.89 min) compared to 6.69 min (standard deviation 5.01 min) (p = 0.176) for interviews conducted face-to-face. Omission or documented error of a regular prescription medication occurred with four patients (6.25%). Two errors were deemed clinically significant with the potential to cause moderate discomfort or clinical deterioration. Conclusion: Medication history interviews via telephone are a suitable alternative to face-to-face medication history-taking in lowrisk elective surgical patients who are unable or not required to attend an elective procedures admission clinic.

Background Bedside medication lockers are widely used in hospitals for storing inpatient and discharge medications; however, there is a risk that inpatient medicines may be inadvertently supplied at discharge. Aim To quantify the extent of inappropriate medications found in bedside medication lockers, in order to develop future strategies to reduce the risk of patients being discharged with inappropriate medications. Methods A pharmacy assistant checked the bedside medication lockers of admitted patients against the current inpatient medication charts twice a week for 2 months in a surgical ward of an Australian tertiary hospital. The pharmacy assistant identified, documented and removed the ceased, non‐prescribed and other patient's medications. The hospital reporting system was queried for reports of non‐prescribed medicines being sent home at discharge at the end of the study period. Results Over 2 months, 533 of 557 (96%) admitted patients had their bedside medication lockers checked on the designated days. Medications were removed from 101 (19%) of the 533 bedside medication lockers checked. Of the 187 medications removed, 73 (39%) were ceased, 104 (56%) were not current and 10 (5%) were labelled with a different patient name. Review of the hospital reporting system did not identify any reports of surgical patients discharged with inappropriate or unlabelled medicines. Conclusion Checking bedside medication lockers by a pharmacy assistant has highlighted a number of inappropriate medications that could potentially be discharged with the patient if appropriate medication reconciliation does not occur. This area of medication management requires further investigation to determine if this process reduces the risk of medication misadventure on discharge.

Background Non‐small cell lung cancer (NSCLC) is the most common form of lung cancer and comprises 75% to 85% of all lung cancer diagnoses. Epidermal growth factor receptor (EGFR) mutation positive disease comprises 10% of patients in the USA and is higher in people of Asian ancestry. Gefitinib and erlotinib are reversible tyrosine kinase inhibitors (TKIs) approved for advanced or metastatic disease but utility is limited by the emergence of resistance. Afatinib, an irreversible TKI, is under investigation for people who have developed TKI resistance. Aim To report a case of a patient with EGFR mutation positive NSCLC who developed resistance to gefitinib and was treated with afatinib. Clinical details A 61‐year‐old female presented with history of cough, malaise and anorexia that had not resolved with antibiotics and increased doses of inhaled corticosteroid. The only other medical history of note was gastro‐oesophageal reflux disease, lupus (mild arthralgia) and irritable bowel syndrome. A CT scan showed unusual lesions throughout the lungs. Bronchial washing (left upper lobe), bronchoalveolar lavage, bronchial brushing (left upper lobe) and transbronchial biopsy were consistent with adenocarcinoma. Biopsy of a right scapular lesion confirmed metastatic adenocarcinoma of the lung. The tumour was found to be positive for an EGFR mutation. Outcomes: After 12 months of therapy, the patient experienced disease progression and afatinib was commenced. After 1 month of treatment, respiratory symptoms and energy levels began to improve. CT imaging showed stable disease. The patient is being followed up on a monthly basis. Conclusion Emerging resistance to reversible TKIs poses a significant problem. Oral irreversible TKIs such as afatinib may offer an effective treatment option with minimal lifestyle interruptions and a predictable toxicity profile.

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