Abstract
Background
Drug-related problems (DRPs) are common among patients seen in the emergency department
(ED), but the true incidence is not clear.
Objectives
The primary objective of this study was to determine the prevalence of DRPs among
patients seen in a U.S. ED. The secondary objective was to categorize these DRPs by
problem type and by medication class.
Methods
This was a prospective observational cohort study of a random sample of ED patients
between December 2011 and March 2013. ED pharmacists screened randomly selected patients
for the presence of a DRP contributing to the ED visit. Four independent auditors
evaluated the results to achieve consensus for the presence or absence of DRPs and
categorization of the DRPs.
Results
Among 1039 patients screened for DRPs, 308 (29.6%) were found to have at least 1 DRP
contributing to the ED visit. Among a total of 443 DRPs, the most commonly identified
categories were adverse drug reaction (n = 193 [43.6%]), ineffective medication (n = 69
[15.6%]), and subtherapeutic dosage (n = 68 [15.3%]). The most commonly implicated
drug classes were cardiovascular medications (n = 113 [26.5%]), anti-infective medications
(n = 52 [12.2%]), and analgesic medications (n = 58 [13.6%]).
Conclusions
A substantial proportion of ED visits are associated in part or in total with DRPs.
Adverse drug reactions and cardiovascular medications are the most common category
and medication class implicated, respectively.
Keywords
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Article info
Publication history
Published online: April 29, 2022
Accepted:
April 23,
2022
Received in revised form:
February 23,
2022
Received:
November 12,
2021
Footnotes
Presented at the American College of Emergency Physician's Scientific Assembly's Research Forum, Denver, CO, 2012, and Chicago, IL, 2014, and published in abstract form: Fowler CL, Baudoin MR, Bellamkonda VR, et al. Drug-related problems in the emergency department: development of a real-time electronic surveillance and notification system. Ann Emerg Med. 2012;60(4):S113; Perinpam L, Haag JD, Baudoin MR, et al. Drug-related problems in emergency department patients: a prospective evaluation of prevalence, categorization, and disposition. Ann Emerg Med. 2014;64(4):S64; Perinpam L, Haag JD, Baudoin MR, et al. Preventability and severity scoring of drug-related problems in the emergency department. Ann Emerg Med. 2014;64(4):S100-S101.
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© 2022 Published by Elsevier Inc.
