Medication-related emergency department visits
Medication-related emergency department visits
Medicines may cause adverse drug reactions or can be used incorrectly, potentially resulting in patient harm. Such harm is referred to as adverse drug events (ADEs). ADEs are a major cause of emergency department (ED) visits and hospital admissions.
The first aim of this thesis of Rehana Rahman was to study how often ADEs lead to medication-related ED visits without subsequent hospital admission, to what extent these medication-related ED visits are preventable, and whether they are recognised by ED physicians. The second aim was to determine whether patients remember medication changes made during an ED visit, and whether these changes are documented in the medical records of healthcare providers, such as general practitioners and community pharmacists. Third, the thesis evaluated the effect and costs of medication reviews in patients who are hospitalised due to an ADE. In addition, it was assessed whether medication reviews are more effective in a specific group of patients, namely those admitted because of medication-related trauma.
Research conducted in two hospitals showed that 17% of ED visits without hospital admission were caused by an ADE, of which more than one third were preventable. In almost two thirds of patients, the ADE was not recognised by the ED physician. Most patients recalled medication changes made during the ED visit; however, these changes were not always documented in the medical records of general practitioners and community pharmacists. Medication reviews in hospitalised patients with an ADE more frequently resulted in medication changes and led to net cost savings compared with standard care. No evidence was found that medication reviews were more effective in the group of patients with medication-related trauma.