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Background Polypharmacy and drug-related problems (DRP) increase the likelihood of negative health outcomes such as adverse reactions, interactions or lack of adherence. Moreover, published studies report DRPs as a frequent cause of hospitalisation and visits to emergency departments (ED), which makes it a target scenario for investigation. Purpose The aim was to analyse DRP and to explore its contribution to visits to the ED. Material and methods Prospective study was carried out in the ED of a tertiary hospital on polymedicated patients (≥5 drugs). Period of intervention: April–September 2018. Pharmacists collected information from previous reports, current emergency reports and prescriptions from the electronic prescribing records. Afterwards, patients were interviewed in order to check the information. The detected DRP were communicated to physicians (primary care, hospital specialist, ED) according to Pharmaceutical Care Network Europe Foundation V6.01 classification which was adapted. The ED physician was asked: ‘Do you think that any drug related problem has been able to contribute to the emergency visit?’ ‘Which one?’ The study is supported by the Ethics Committee of Gipuzkoa Health Area. Results One-hundred and one of 138 patients (73%) presented some DRP. The pharmacists considered that in 65 of 116 patients (47%) the DRP contributed to the visit to the ED. Thirty-three (50%) were male, mean age 75 years and an average of 9.2 prescriptions. The main reasons to go to the ED were: 16 (24%) dyspnea, six (9%) melaena, six (9%) dizziness and five (7.5%) general discomfort. DRP considered related to the visit were: 31 (47.7%) adverse effect, 20 (30.8%) adequate therapy but ineffective, three (4.6%) high dose, three (4.6%) lack of adherence, three (4.6%) indication without drug and four (6.2%), other. The ED physician agreed with the pharmacist in 94% of the cases, Cohens kappa: 0.913. Conclusion The prevalence of DRP and its contribution to the ED visit is higher than in other studies. 1, 2 Maybe this is due to a different methodology and patients’ characteristics (age, polypharmacy). 3 There is a high degree of agreement between the pharmacist and the ED physician in assessing the cases of DRP and the ED visit. The integration of a pharmacist in the ED has facilitated the detection of DRP and helped to identify their link with ED visits. References and/or acknowledgements 1. https://www.ncbi.nlm.nih.gov/pubmed/12126224 2. https://www.ncbi.nlm.nih.gov/pubmed/24493969 3. https://www.ncbi.nlm.nih.gov/pubmed/25795686 No conflict of interest. |
