Medication use in the emergency department: Why are we placing patients at risk?

Cobaugh, Daniel J.; Schneider, Sandra

doi:10.2146/ajhp050016

Cited by 30 publications

(17 citation statements)

References 6 publications

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“…It has been shown that in the ED patients are at risk of receiving suboptimal medication compared to that provided in inpatient and ambulatory care settings 7. Identifying and characterising inappropriate prescribing at the ED would show the need for clinical pharmacy services in this setting and could be the next step for developing a robust model of practice specifically for the ED.…”

Section: Introductionmentioning

confidence: 99%

Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

West

Cordina

Cunningham

2012

Pharmacy Practice (Internet)

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Appropriate prescribing remains an important priority in all medical areas of practice.ObjectiveThe objective of this study was to apply a Medication Appropriateness Index (MAI) to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED).MethodsThis study was carried out at Malta's general hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on medication therapy were included. Medication treatment for inappropriateness was assessed by using the MAI. Under-prescribing was also screened for.ResultsTreatment charts of 125 patients, including 697 medications, were assessed using a MAI. Overall, 115 (92%) patients had one or more medications with one or more MAI criteria rated as inappropriate, giving a total of 384 (55.1%) medications prescribed inappropriately. The mean SD MAI score per drug was 1.78 (SD=2.19). The most common medication classes with appropriateness problems were biguanides (100%), anti-arrhythmics (100%) and anti-platelets (96.8%). The most common problems involved incorrect directions (26%) and incorrect dosages (18.5%). There were 36 omitted medications with untreated indications.ConclusionsThere is considerable inappropriate prescribing which could have significant negative effects regarding patient care.

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Section: Introductionmentioning

confidence: 99%

Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

West

Cordina

Cunningham

2012

Pharmacy Practice (Internet)

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“…The complexity and conditions in which medications are used in the ED speak to the need for more pharmacy departments to assess the possibility of increasing patient care services by pharmacists in the ED. 27 Operating expenses. Prior-year inpatient pharmacy acquisition cost of pharmaceuticals, including drug products derived from blood and diagnostic agents but excluding i.v.…”

Section: Outsourcing Of Medication Preparation and Returnsmentioning

confidence: 99%

ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration—2005

Pedersen¹,

Schneider

Scheckelhoff

2006

American Journal of Health-System Pharmacy

172

109

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“…Recently, influential organizations such as the Institute of Medicine have supported the increased utilization of EPh roles 9, 10…”

Section: Introductionmentioning

confidence: 99%

“…5,7,9,11 Although the presence of Emergency Pharmacists has previously been reported as low, their prevalence in EDs with EM physician residency programs is unknown. Therefore, the goal of this study was to determine the prevalence and nature of clinical pharmacy services in academic EDs.…”

Section: Introductionmentioning

confidence: 99%

Survey of physicians regarding clinical pharmacy services in academic emergency departments

Szczesiul

Fairbanks²,

Hildebrand³

et al. 2009

American Journal of Health-System Pharmacy

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Objectives Previous reports have shown that clinical pharmacists improve quality of care, but the extent of pharmacist involvement in emergency departments (EDs) is unknown. The objective of this study was to determine the prevalence and nature of clinical pharmacy services in academic EDs. Methods All programs listed in a national Emergency Medicine physician residency catalog in June 2006 were surveyed using a web-based survey instrument, which was developed based on literature and expert consensus. Only the primary residency hospital sites were considered. Data were compiled and analyzed using descriptive statistics and 95% confidence intervals. Results Of the 135 emergency medicine (EM) residency programs surveyed, there were 99 responses (73%). Eight percent of institutions reported that clinical pharmacy services were available 24-hours a day, 22% reported partial coverage, and 70% reported no coverage. Six percent reported the presence of a satellite pharmacy located in the ED and staffed by a pharmacist. The most common clinical pharmacy services reported in EDs with pharmacy coverage were modification of inventory according to formulary status, the provision of drug or toxicology information, and adverse drug event reporting. Even among institutions which had availability of clinical pharmacists, most did not provide services which have been shown to be valued, such as drug therapy recommendations, cost-effectiveness advice, patient counseling, or medical student and resident education. Conclusions A minority of academic EDs provide clinical pharmacy services with a dedicated clinical pharmacist. EM residency programs should lead the way in the integration of clinical pharmacists in emergency care.

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Medication use in the emergency department: Why are we placing patients at risk?

Cited by 30 publications

References 6 publications

Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration—2005

Survey of physicians regarding clinical pharmacy services in academic emergency departments

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