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Drug-related visits to the emergency department in a Spanish university hospital

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Abstract

Background Negative outcomes of medications (NOMs) are a major public health problem that impact on patients’ quality of life. As many NOMs are avoidable, it is necessary to determine their causes in each health setting in order to plan preventive strategies. Objective The aims of this study were to assess the frequency, type, severity, and preventability of NOMs that result in emergency department visits, to identify the main medications involved, and to determine factors associated with their development in a general hospital in Spain. Setting Emergency department of a 650-bed university tertiary hospital. Methods Descriptive, cross-sectional study. On each study day, a pharmacist administered a questionnaire to one in every three patients awaiting consultation. Information was also obtained from the emergency medical records. Emergency department visits were identified as NOMs on the basis of assessment by a pharmacist and a physician. A second pharmacist and physician reassessed the same cases. Discrepancies were adjudicated by an external team of two pharmacists and a physician. Main outcome measures number of NOMs detected, severity and preventability of the NOMs detected, medications involved in these NOMs, and factors associated with NOMs. Results A NOM was detected in 221 of 588 patients analyzed (37.6 %). In relation to NOM severity, 59.3 % were mild, 34.4 % were moderate and 6.3 % were severe. One hundred and fifty-seven of the 221 NOMs (71 %) were considered preventable. Drugs most frequently involved in NOMs were nervous system agents (22.1 %), musculo-skeletal system agents (19.1 %), and anti-infective agents for systemic use (17.6 %). Mean number of drugs taken was the only factor associated with NOMs. Conclusion The high number of NOMs detected indicates that closer pharmacotherapy follow up is needed to avoid such events in our setting.

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Acknowledgments

The authors thank the physicians in the ED and the pharmacists of the Pharmacy Department who participated in this study, as well as to Carolyn Newey for her assistance with the manuscript and I. Gich for supporting statistical analysis.

Funding

Data from this study correspond to part of a research project funded by the National Health Research Fund.

Conflicts of interest

None.

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Authors and Affiliations

  1. Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Sant Quintí 89, 08041, Barcelona, Spain

    Isabel Castro, Laura Tuneu, Mª Luisa Sala & Mª Antonia Mangues

  2. Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    José Mª Guardiola

  3. School of Pharmacy, University of Granada, Granada, Spain

    Mª José Faus

Authors
  1. Isabel Castro
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  2. José Mª Guardiola
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  3. Laura Tuneu
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  4. Mª Luisa Sala
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  5. Mª José Faus
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  6. Mª Antonia Mangues
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Correspondence to Isabel Castro.

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Castro, I., Guardiola, J.M., Tuneu, L. et al. Drug-related visits to the emergency department in a Spanish university hospital. Int J Clin Pharm 35, 727–735 (2013). https://doi.org/10.1007/s11096-013-9795-7

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  • DOI: https://doi.org/10.1007/s11096-013-9795-7

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