CMAJ • June 3, 2008; 178 (12). doi:10.1503/cmaj.071594.
© 2008 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Résumé
Right arrow Online Appendices
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Zed, P. J.
Right arrow Articles by Purssell, R. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zed, P. J., PharmD
Right arrow Articles by Purssell, R. A., MD
Related Collections
Right arrow Other emergency medicine
Right arrow Adverse drug reactions
Right arrowRelated Articles

Research

Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study

Peter J. Zed, PharmD, Riyad B. Abu-Laban, MD MHSc, Robert M. Balen, PharmD, Peter S. Loewen, PharmD, Corinne M. Hohl, MD, Jeffrey R. Brubacher, MD MSc, Kerry Wilbur, PharmD, Matthew O. Wiens, BSc(Pharm), Leslie J. Samoy, BSc(Pharm), Katie Lacaria, BSc(Pharm) and Roy A. Purssell, MD

From the Department of Pharmacy (Zed), Queen Elizabeth II Health Sciences Centre, Capital Health, Halifax, NS; the Department of Emergency Medicine and College of Pharmacy (Zed), Dalhousie University, Halifax, NS; the Department of Emergency Medicine (Abu-Laban, Hohl, Brubacher, Purssell) and the Pharmaceutical Sciences Clinical Services Unit (Samoy, Lacaria), Vancouver General Hospital, Vancouver, BC; the Faculty of Medicine (Abu-Laban, Hohl, Brubacher, Purssell) and the Faculty of Pharmaceutical Sciences (Balen, Loewen, Wiens), University of British Columbia, Vancouver, BC; Pharmacy Services (Balen), Royal Columbian Hospital, New Westminster, BC; Pharmacy Services (Loewen), Vancouver Coastal Health — Providence Health Care, Vancouver, BC; and the Pharmacy Program (Wilbur), Qatar University, Doha, Qatar

Correspondence to: Dr. Peter J. Zed, Queen Elizabeth II Health Sciences Centre, Department of Pharmacy — Halifax Infirmary, 1796 Summer St., Halifax NS B3H 3A7; fax 902 473-3904; peter.zed{at}dal.ca

Background: Medication-related visits to the emergency department are an important but poorly understood phenomenon. We sought to evaluate the frequency, severity and preventability of drug-related visits to the emergency department.

Methods: We performed a prospective observational study of randomly selected adults presenting to the emergency department over a 12-week period. Emergency department visits were identified as drug-related on the basis of assessment by a pharmacist research assistant and an emergency physician; discrepancies were adjudicated by 2 independent reviewers.

Results: Among the 1017 patients included in the study, the emergency department visit was identified as drug-related for 122 patients (12.0%, 95% confidence interval [CI] 10.1%–14.2%); of these, 83 visits (68.0%, 95% CI 59.0%–76.2%) were deemed preventable. Severity was classified as mild in 15.6% of the 122 cases, moderate in 74.6% and severe in 9.8%. The most common reasons for drug-related visits were adverse drug reactions (39.3%), nonadherence (27.9%) and use of the wrong or suboptimal drug (11.5%). The probability of admission was significantly higher among patients who had a drug-related visit than among those whose visit was not drug-related (OR 2.18, 95% CI 1.46–3.27, p < 0.001), and among those admitted, the median length of stay was longer (8.0 [interquartile range 23.5] v. 5.5 [interquartile range 10.0] days, p = 0.06).

Interpretation: More than 1 in 9 emergency department visits are due to drug-related adverse events, a potentially preventable problem in our health care system.


Related Articles

Highlights of this issue
Can. Med. Assoc. J. 2008 178: 1517. [Full Text] [PDF]

Dans ce numéro
Can. Med. Assoc. J. 2008 178: 1517. [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Am J Health Syst PharmHome page
T. C. Randolph
Expansion of pharmacists' responsibilities in an emergency department
Am. J. Health Syst. Pharm., August 15, 2009; 66(16): 1484 - 1487.
[Abstract] [Full Text] [PDF]

Home page
 CMAJHome page
N. J. MacKinnon and I. Ip
The National Pharmaceuticals Strategy: Rest in peace, revive or renew?
Can. Med. Assoc. J., April 14, 2009; 180(8): 801 - 803.
[Full Text] [PDF]