Medicine-related problems resulting in emergency department visits

Baena, M. I.; Faus, María José; Fajardo, Paloma C.; Luque, Francisco M.; Sierra, Francisco; Martínez-Olmos, José; Cabrera, Andrés; Fernández-Llimós, Fernando; Martínez-Mart́inez, Fernando; Jiménez, José María López; Zarzuelo, Antonio

doi:10.1007/s00228-006-0116-0

Cited by 87 publications

(73 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Morbidity and mortality associated with medication is widely described in the literature. Over 20 % of visits to emergency departments are related to medicines use [2][3][4]. In the U.S., drug related problems (DRPs) represent the 4th-6th leading cause of death and adverse reactions are responsible for 3-6 % of hospitalizations (700,000 patients/year) [5], representing an estimated cost of 130 billion dollars [6].…”

Section: Introductionmentioning

confidence: 99%

Drug-related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention

Silva

Ramalho²,

Luz³

et al. 2015

Int J Clin Pharm

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Drug-related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention

Silva

Ramalho²,

Luz³

et al. 2015

Int J Clin Pharm

View full text Add to dashboard Cite

show abstract

“…Studies in both outpatient [30] and hospital settings have shown that most NOM detected could be avoided, up to 70% in some cases [31,32]. Through opportune interventions, NOM could be avoided altogether [33].…”

Section: Discussionmentioning

confidence: 99%

Drug Therapy Monitoring in Patients with Type 2 Diabetes and Hypertension

Bolívar¹,

Martínez-Mart́inez²,

Ferrit-Martin³

2017

JPP

View full text Add to dashboard Cite

Abstract:The aim of this paper is to detect, prevent and resolve DRP (drug-related problems) and NOM (negative outcomes associated with medication) in hospitalized patients with DM2 (type 2 diabetes) with HTN (hypertension) in a tertiary care clinic. Descriptive cross-sectional interventional study is used. DTM (drug therapy monitoring) was conducted in 73 patients using data obtained from clinical histories and interviews. NOM were detected based on symptoms and laboratory test results. The statistical significance was 0.05. It can be found that 23 DRP were detected, primarily in the category "likelihood of adverse effects" (30.43%) causing NOM in the "non-quantitative safety problem" category. The NOM detected were related to safety (62%), effectiveness (24.5%) and necessity (13.5%). Of the 68.57% of pharmacist interventions accepted, 48.57% were resolved and 20% were not resolved. A simple linear correlation (r = −0.34) analysis indicated a weak association between patient age and severity of NOM. DTM made it possible to detect suspected DRP and NOM, which were then prevented or resolved, improving the control of HTN and DM2 and helping ensure better drug therapy outcomes for patients.

show abstract

“…Outcomes beyond the optimal medication intended outcomes may be defined as new medical problems produced by the medication, and categorised in adverse drug reactions (ADRs), drug dependence and abuse, and intoxications by overdose (21). Previous studies on DRMs, mainly conducted in emergency and inpatient settings, have found that ADRs and STEs are the most common DRMs (22)(23)(24)(25)(26)(27). DRMs have been associated with worsening of quality of life of patients (28)(29)(30), mortality (31)(32)(33), and increased costs for healthcare and society (20,34,35).…”

Section: Drug-related Morbiditiesmentioning

confidence: 99%

Inappropriate prescribing, non-adherence to long-term medications and related morbidities : Pharmacoepidemiological aspects

Hedna

2015

View full text Add to dashboard Cite

Aim:The aim of this thesis is to estimate and analyse the burden of potentially inappropriate prescriptions (PIPs) in the elderly and non-adherence to long-term medications among adults across care settings, and to investigate how IUM is associated to DRMs. Methods:A meta-analysis summarised the previous evidence on the percentage of adverse drug reactions (ADRs) associated to IUM across healthcare settings (Study I). From a cohort in the general population, using medical records and register data, the prevalence of PIPs in the elderly and its association with ADRs were estimated retrospectively (Study II). From the same cohort, the factors associated with refill non-adherence to antihypertensive therapy, considering the use of multiple medications, and the association between non-adherence and sub-therapeutic effects (STEs) were investigated (Study III). A survey assessed the refill behaviour to antihypertensive, lipid lowering and oral antidiabetic medications (undersupply, adequate supply and oversupply), and its association with perceived ADRs and STEs (Study IV).Results: IUM was the cause 52% and 45% of ADRs occurring in adult outpatients and inpatients respectively. Across healthcare settings, 46% of the elderly refilled PIPs over a 6-month period;PIPs were considered the cause of 30% of all ADRs; and the elderly who were prescribed PIPs had increased odds to experience ADRs (OR 2.47, 95% CI 1.65-3.69). In total, 35% was nonadherent to the full multidrug therapy and 13% was non-adherent to any medication (complete vi non-adherence). Sociodemographic factors (working age and lower income) were associated with non-adherence to any medication, while clinical factors (use of specialised care, use of multiple medications, and being a new user) with non-adherence to the full multidrug therapy. STEs were associated with non-adherence to any medication a month prior to a healthcare visit (OR 3.27, 95% CI 1.27-8.49), but not with long-term measures of non-adherence. Among survey respondents, 22% of the medications were oversupplied and 12% were undersupplied. Inadequate refill behaviour was not associated with reporting ADRs or STEs (p<0.05). Conclusions:A large proportion of ADRs occurring in hospital is caused by IUM, but more knowledge is needed in other settings. PIPs are common in the elderly general population and associated with ADRs. Therefore decreasing PIPs could contribute towards ADR prevention.Considering the use of multiple medications may help to better understand the factors associated with non-adherence to a multidrug therapy for tailoring the interventions to patient needs.Monitoring the adherence prior to a healthcare visit may facilitate interpreting STEs. Yet, the absence of an association between long-term measures of refill non-adherence with clinical and perceived DRMs suggest the need to enhance the knowledge of this association in clinical practice.In summary, this thesis shows a significant potential for improvements of medication use and outcomes.Key words: Drug-related morbidity, medica...

show abstract

Medicine-related problems resulting in emergency department visits

Abstract: The prevalence of negative clinical outcomes was 33%, of which more than 73% of these were preventable. Factors associated with their appearance were age, number of medicines, and their combined effect.

Cited by 87 publications

References 31 publications

Drug-related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention

Drug-related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention

Drug Therapy Monitoring in Patients with Type 2 Diabetes and Hypertension

Inappropriate prescribing, non-adherence to long-term medications and related morbidities : Pharmacoepidemiological aspects

Contact Info

Product

Resources

About