Medication-related visits to the emergency department: A prospective study

OBJECTIVE: TO assess the prevalence, preventability, category, and severity of drug-related problems; medications involved; common causes of preventab le medication-related visits (MRVs); and cost of MRVs. METHODS: In this prospective, observational study of emergency department v isits, patients were identified as having MRVs by use of a questionnaire. T he patients or their representatives were interviewed to assess whether the emergency department visit was caused by a medication-related problem Pati ent selection was consecutive. A blinded panel of pharmacists and one physi cian was used to assess study objectives. RESULTS: Of the 253 patients interviewed, 71 patients (28.1%) presenting to the emergency department had a medication-related reason for their visits. Of the 71 MRVs, 50 (70.4%) were judged to be preventable and 21 (29.6%) no npreventable. The data showed that MRVs are most often caused by an adverse drug reaction, followed by overprescribing of the correct medication. The severity of MRVs was most often classified as moderate. The most common med ications involved were cardiovascular agents. The preventable MRVs were mos tly due to noncompliance issues, inappropriate prescribing, inappropriate m onitoring, and lack of patient education The average cost to the institutio n was approximately $1444 per preventable MRV. CONCLUSIONS: In our study, the prevalence of MRVs was higher than in previo us studies due to the prospective nature of the study and the assistance of drug experts in identifying and classifying the incidents. Areas identifie d for improvement included compliance issues with patients, education of he althcare workers regarding prescribing and monitoring of medications, and p atient education.