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AuthorZed, P.J.
AuthorAbu-Laban, R.B.
AuthorBalen, R.M.
AuthorLoewen, P.S.
AuthorHohl, C.M.
AuthorBrubacher, J.R.
AuthorWilbur, K.
AuthorWiens, M.O.
AuthorSamoy, L.J.
AuthorLacaria, K.
AuthorPurssell, R.A.
Available date2010-01-03T08:05:44Z
Publication Date2008
Publication NameCanadian Medical Association Journal
CitationZed, 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
URI 10.1503/cmaj.071594
AbstractBackground: 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.
PublisherCanadian Medical Association
Subjectemergency department
TitleIncidence, severity and preventability of medication-related visits to the emergency department: A prospective study

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