Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/22490
Title: Comprehensive identification of medication-related problems occurring prior to, during and after emergency department presentation: An Australian multicentre, prospective, observational study.
Authors: Taylor, Simone E;Mitri, Elise A;Harding, Andrew M;Taylor, David McD;Weeks, Adrian;Abbott, Leonie;Lambros, Pani;Lawrence, Dona;Strumpman, Dana;Senturk-Raif, Reyhan;Louey, Stephen;Crisp, Hamish;Tomlinson, Emily;Manias, Elizabeth
Affiliation: Pharmacy Department, Austin Health, Heidelberg, Victoria, Australia
Pharmacy Department, Manly Hospital, Sydney, New South Wales, Australia
Pharmacy Department, Northern Health, Melbourne, Victoria, Australia
Pharmacy Department, Eastern Health, Box Hill Hospital, Melbourne, Victoria, Australia
Pharmacy Department, Barwon Health, Geelong, Victoria, Australia
Pharmacy Department, Western Health, Melbourne, Victoria, Australia
Department of Emergency Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
Centre for Quality and Patient Safety Research, Deakin University, Melbourne, Victoria, Australia
Pharmacy Department, Launceston General Hospital, Launceston, Tasmania, Australia
Emergency Department, Monash Health, Casey Hospital, Melbourne, Victoria, Australia
Pharmacy Department, Monash Health, Dandenong Hospital, Melbourne, Victoria, Australia
Pharmacy Department, Prince of Wales Hospital, Sydney, New South Wales, Australia
Issue Date: 22-Jan-2020
EDate: 2020
Citation: Emergency medicine Australasia : EMA 2020; online first: 22 January
Abstract: Patients present to EDs with various medication-related problems (MRPs). MRPs are also associated with ED care, occurring during ED presentation or shortly afterwards. The aim of the present study is to describe the prevalence and nature of MRPs that occur prior to, during or shortly after leaving ED. We undertook a prospective, observational study in nine Australian EDs. Blocks of 10 consecutive adult patients who were not seen by a pharmacist in ED and who presented at pre-specified times were identified. Within 1 week of ED discharge, a pharmacist interviewed patients and undertook a medical record review to determine their medication history, patients' understanding of treatment, potential MRP risk factors and manage any identified MRPs. A total of 904 patients were recruited: 14.8% aged ≥80 years, 18.9% taking more than eight regular medications; 581 MRPs were identified; 287 (49.4%, 95% confidence interval [CI] 45.3-53.5%) of moderate-high significance. Most highly significant MRPs involved high-risk medications, particularly strong opioids, insulin and anti-coagulants. The most common types of MRPs were prescribing errors (46.8%), patient adherence/knowledge issues (31.2%) and adverse drug reactions (7.4%). Of all patients, 381 (42.1%, 95% CI 38.9-45.5%) had at least one MRP; 31.4% (95% CI 28.4-34.6%) had MRPs that could be identified or managed by screening at ED presentation and 12.4% (95% CI 10.4-14.8%) had MRPs that could be identified or managed by screening at ED discharge. Patients experienced a range of MRPs throughout the ED continuum of care. From these data, screening tools will be developed so that ED clinicians may identify patients at greatest risk of MRPs.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22490
DOI: 10.1111/1742-6723.13439
ORCID: 0000-0002-0592-518X
0000-0003-3992-7316
0000-0002-8986-9997
0000-0002-8361-4774
0000-0002-3747-0087
PubMed URL: 31970884
Type: Journal Article
Subjects: adverse drug event
continuum of care
emergency department
medication-related problem
Appears in Collections:Journal articles

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