Background and importance Medication-related admissions (MRAs) are common in the elderly and are preventable in almost half of cases. Pharmaceutical care aims to promote medication safety and reduce potentially inappropriate prescriptions. In our hospitals, clinical pharmacists perform medication reviews in both the emergency department (ED) and orthopedic units. As part of an ongoing process of quality improvement, we conducted a study to identify MRAs in patients over 75 years old hospitalised in these two clinical settings.

Aim and objectives The aim of this study was to compare MRAs prevalence in elderly patients hospitalised in the ED and orthopedic units in order to reassess the management of clinical pharmacists’ interventions during hospitalisations.

Material and methods This prospective observational multicentre study was conducted between May 2019 and March 2020, and included patients aged over 75 years admitted to the ED and orthopedic surgery departments of two French hospitals. We used the AT-HARM10 tool to distinguish possibly versus unlikely MRAs in elderly patients.

Results We included 266 patients. 166 patients were included in the ED (mean age 86.0±5.7 years; sex ratio 0.6; mean number of prescribed drugs 7.7±3.8). 100 patients were included in the orthopedic surgery departments (mean age 85.2±6.1 years; sex ratio 0.3; mean number of prescribed drugs 6.4±3.6). We identified 91 (55%) MRAs in ED and 75 (75%) MRAs in orthopedic units (p<0.05). Among MRAs, the most represented question of the AT-HARM10 was P5 in both groups (Might side effects of the medications the patient was taking prior to hospitalisation have caused the admission?) and the most involved drugs were those acting on the nervous system (ATC-N).

Conclusion and relevance We found MRAs rates comparable to results reported in previous studies about elderly patients in ED. MRAs were more frequent in elderly patients admitted in orthopedic surgery. These results led us to prioritise more medication reviews by clinical pharmacists for older patients in surgery departments, to guarantee a continuity of patient’s care and potentially avoid re-hospitalisations.

Conflict of interest No conflict of interest