RT Journal Article
SR Electronic
T1 Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1563
OP 1569
DO 10.1503/cmaj.071594
VO 178
IS 12
A1 Peter J. Zed, PharmD
A1 Riyad B. Abu-Laban, MD MHSc
A1 Robert M. Balen, PharmD
A1 Peter S. Loewen, PharmD
A1 Corinne M. Hohl MD
A1 Jeffrey R. Brubacher, MD MSc
A1 Kerry Wilbur, PharmD
A1 Matthew O. Wiens, BSc(Pharm)
A1 Leslie J. Samoy, BSc(Pharm)
A1 Katie Lacaria, BSc(Pharm)
A1 Roy A. Purssell MD
YR 2008
UL http://www.cmaj.ca/content/178/12/1563.abstract
AB 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.