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

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Author Zed, P.J. en_US
Author Abu-Laban, R.B. en_US
Author Balen, R.M. en_US
Author Loewen, P.S. en_US
Author Hohl, C.M. en_US
Author Brubacher, J.R. en_US
Author Wilbur, K. en_US
Author Wiens, M.O. en_US
Author Samoy, L.J. en_US
Author Lacaria, K. en_US
Author Purssell, R.A. en_US
Available date 2010-01-03T08:05:44Z en_US
Publication Date 2008 en_US
Citation Zed, P. J., Abu-Laban, R. B., Balen, R. M., Loewen, P. S., Hohl, C. M., Brubacher, J. R., … Purssell, R. A. (2008). Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study. Canadian Medical Association Journal , 178 (12 ), 1563–1569 en_US
URI http://dx.doi.org/ 10.1503/cmaj.071594 en_US
URI http://hdl.handle.net/10576/10598 en_US
Abstract 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.o%-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. en_US
Language en en_US
Publisher Canadian Medical Association en_US
Title Incidence, severity and preventability of medication-related visits to the emergency department: A prospective study en_US
Type Article en_US


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