Background According to recent studies conducted at Emergency Departments (ED) a large number of adverse events (AE) are due to drug-related problems (DRP). For this reason some hospitals are incorporating clinical pharmacists into the ED team.
Purpose To analyse data on pharmaceutical interventions (PI) conducted in the ED.
To evaluate the correlation between interventions and patient risk factors.
Materials and methods Prospective interventional trial of 4 months conducted in ED patients awaiting admission. The activities carried out by the pharmacist were: drug reconciliation, pharmacotherapy reviews, answer questions and provide drug information to medical staff.
The variables recorded were: sex, age, pharmacological treatment including high-risk drugs (anticoagulants, antiplatelet agents, antiepileptics, oral antidiabetic, digoxin, insulin, morphine), Charlson Comorbidity Index (CCI) and PI.
Results 336 patients were included (average age 76). 52.0% (175) were men. 79.8% (268) had a home prescription with ≥5 drugs. PI (827; 10.5 interventions/day), were performed on 85.7% of the patients. 61.0% of the interventions (506) were to correct mistakes of omission. The pharmacological group that engendered more PI was the antihypertensives (18.1%). 79.7% of the patients receiving <2 high risk drugs needed PI, whereas 90.5% of patients with ≥2 received PI (p = 0.014). Interventions were made in 79.3% of the patients with CCI <2, whereas in the patients with CCI ≥ 2 85.9% needed PI (p < 0.01).
Conclusions The presence of a clinical pharmacist in the multidisciplinary ED team has been shown to improve patient care, correcting reconciliation mistakes.
Patients with CCI ≥ 2 and habitual treatment ≥2 high risk drug are likely to suffer DRP and most likely require PI. The correlation between risk factors studied and PI, allows the pharmaceutical monitoring to focus on these patients.
No conflict of interest.
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