Comorbidities, potentially dangerous and low therapeutic index medications: factors linked to emergency visits

Tramontina, Mariana Younes; Ferreira, Maria Beatriz Cardoso; Castro, Mauro Silveira de; Heineck, Isabela

doi:10.1590/1413-81232018235.07512016

Cited by 4 publications

(3 citation statements)

References 25 publications

(29 reference statements)

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“…There are reports suggesting that infection or trauma could worsen chronic illnesses such as chronic heart disease and chronic obstructive pulmonary disease. These patients were at greater risk of developing infectious complications and be discharged to hospital care settings [15,16,17]. Complications of oropharyngeal infections and neck phlegmons were frequent indications for hospitalization and surgical treatment in our study.…”

Section: Department Of Otorhinolaryngology and Maxillofacial Surgery mentioning

confidence: 69%

Otorhinolaryngology emergency department hospitalizations in a secondary medical center

et al. 2021

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Introduction/Objective. Overall number of emergency department visits, including otorhinolaryngology, has increased. Due to population growth, industry and traffic expansion, workload of the otorhinolaryngology emergency department is steadily on the rise. The objective of this study was to determine most common indications for emergency hospitalization in otorhinolaryngology department in secondary medical center. Also, we examined course of diagnostics and treatment upon admittance, outcome of hospitalization and possible referral to tertiary medical center. Methods. Retrospective study included patients who were urgently hospitalized on the Department of otorhinolaryngology and maxillofacial surgery in Djordje Joanovic General Hospital in Zrenjanin in a two-year period. The data were obtained by processing patients? medical charts. Results. The study included 428 patients who were urgently hospitalized on the Department of otorhinolaryngology of the secondary medical center in two-year period. 245 (57.2%) were male and were 183 (42.8%) female, with average age of 48.5 years. Patients were most frequently hospitalized because of tonsillopharyngitis and its? complications, followed by head and neck trauma. Most of the patients were treated conservatively with medication therapy (72%), and 28% underwent surgical or other invasive intervention. 27 (6.3%) patients were referred to tertiary medical center, which was correlated significantly with number of comorbidities and consultative exams. Conclusion. Otorhinolaryngology inflammatory/infectious diseases are the most frequent indication for urgent hospital admission in secondary medical center. Most of the patients were treated conservatively. Referral to tertiary medical center was significantly correlated to number of comorbidities and consultative exams.

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Section: Department Of Otorhinolaryngology and Maxillofacial Surgery mentioning

confidence: 69%

Otorhinolaryngology emergency department hospitalizations in a secondary medical center

et al. 2021

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“…Adverse drug reactions (ADRs) impose a major burden on healthcare systems and patients alike and they are often associated with worse clinical outcomes, higher costs, and lower treatment adherence [1][2][3][4]. It is not uncommon for patients to present to the emergency department (ED) when such ADRs occur [5,6]. Indeed, ADRs can have serious consequences such that patients need to be hospitalized [7,8].…”

Section: Introductionmentioning

confidence: 99%

A prospective intervention study to identify drug-related emergency department visits comparing a standard care group and a pharmaceutical care group

Hellinger,

Gries,

Schiek

et al. 2023

European Journal of Emergency Medicine

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Background and importance Adverse drug reactions impose a major burden. Those adverse drug reactions might lead to hospitalization but are often not correctly identified in the emergency department (ED). Clinical pharmacists, although not routinely implemented, can help identify adverse drug reactions. Objective The primary objective was to examine the drug association of ED visits in a pharmaceutical group with a clinical pharmacist integrated in the ED team compared with a standard group without additional support. Design/setting/participants This prospective intervention study was performed in the ED of a tertiary care university hospital in Leipzig, Germany. Patients who were ≥50 years old were included. From 1 March 2020 to May 31, 2020 patients were enrolled in the standard group. From 1 March 2021 to 31 May 2021, the pharmaceutical group was enrolled. The clinical pharmacist supported the ED team with patient´s detailed medication history and medication analysis. In both groups, patients were evaluated whether their ED visit was drug-related. Outcome measures and analysis The number of identified drug-related ED presentations were compared between the two groups. Interventions performed on adverse drug reaction management, causative drugs and patient characteristics were evaluated. Main results A total of 798 patients were enrolled in the standard group and 827 patients in the pharmaceutical group. Patients whose ED visit was drug-related had a median age of 77 years [(Q25–Q75) 63.5–83.5] and took 7 [(Q25–Q75) 5–8] drugs in standard group. In the pharmaceutical group median age was 78 years [(Q25–Q75) 66–83] and number of drugs taken was 9 [(Q25–Q75) 5.25–11]. 31 (3.9%) drug-related ED visits were identified in the standard group compared to 104 (12.6%) in the pharmaceutical group (OR 3.56; 95% CI 2.35–5.38). An intervention on the patient’s pharmacotherapy was performed in 16 drug-related ED visits in standard group compared to 77 in the pharmaceutical group. Conclusion In this study the implementation of a clinical pharmacist was associated with improved identification of drug-related ED visits. Discontinuations of causal medications and dose reductions were significantly higher in the pharmaceutical group compared to the standard care group.

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“…However, unnecessary or incorrect use of medications can trigger or aggravate morbidities, compromising users' quality of life or even causing death, being the drug-related morbidities currently considered a public health problem. 2 There are different types of problems associated with medications, some are preventable and some are not. In the same way they may or may not result in damage.…”

Section: Introductionmentioning

confidence: 99%

Factors associated to potential drug interactions in one Intensive Care Unit: a cross-sectional study

Cortes

Silvino

2019

Esc. Anna Nery

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Objective: to identify the factors associated to Potential Drug Interactions with High Alert Medications in the Intensive Care Unit of a Sentinel Hospital. Methods: a cross-sectional, retrospective study using a quantitative approach carried out at a Sentinel Hospital in Rio de Janeiro. The research was based on the analysis of the prescriptions of patients hospitalized in the Intensive Care Unit of the Hospital, in a period of one year, in order to identify the drug interactions related to high alert medications in these prescriptions. Results: Of the 60 prescriptions analyzed, 244 were selected. In these prescriptions, 846 potential drug interactions related to high alert medications and 33 high alert medications were identified. Of the 112 types of potential drug interactions identified, some were more recurrent: tramadol e ondansetron, midazolam and omeprazole, regular insulin and hydrocortisone, fentanyl and midazolam, and regular insulin and noradrenaline. The variables polypharmacy, length of hospital stay, and some specific medications were associated with drug interactions with high alert medications. Conclusion and Implications for practice: It is important to strengthen strategies to reduce adverse drug events. Therefore, the relevance of studies that investigate the origin of these events is highlighted. Drug interactions can represent medication errors. It’s indispensable to work with strategies to better manage the medication system.

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Comorbidities, potentially dangerous and low therapeutic index medications: factors linked to emergency visits

Cited by 4 publications

References 25 publications

Otorhinolaryngology emergency department hospitalizations in a secondary medical center

Otorhinolaryngology emergency department hospitalizations in a secondary medical center

A prospective intervention study to identify drug-related emergency department visits comparing a standard care group and a pharmaceutical care group

Factors associated to potential drug interactions in one Intensive Care Unit: a cross-sectional study

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