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The following is a summary of the study, “Prevalence and factors associated with preventable drug-related emergency department visits (DREDp) in elderly patients,” published in the October 2024 issue of Emergency Medicine by Phoemlap et al.

Emergency department (ED) visits among elderly patients are on the rise, but the impact of drug-related problems (DRPs) on these visits is often overlooked. For this study, researchers aimed to examine the prevalence of preventable drug-related ED visits (DRED_f) in elderly patients and to identify factors associated with these occurrences through comprehensive medication reviews.

This cross-sectional study was conducted in a non-trauma ED at a tertiary-care hospital. It included elderly patients (aged 60 years and older) who were on medications at the time of their ED visit. A clinical pharmacist conducted a detailed medication review for each patient. ED visits were classified as drug-related (DRED) if the primary reason was linked to a DRP, as determined by both the treating physician and pharmacist. DRPs caused by medication errors were classified as preventable, and other DRPs were assessed for preventability using modified Schumock and Thornton criteria.

Among the 351 patients included in the study, with a mean age of 75.5 years, 43 (12.3%) experienced DRED_f, representing 58.1% of all drug-related ED visits (74 patients, 21.1%). Approximately half of the DREDp cases (51.2%) involved medication errors that caused harm (categorized as level E or higher). 

The majority of drug-related visits were caused by adverse drug events (ADEs), particularly involving antithrombotics, oral hypoglycemic agents, and antineoplastic drugs. Further analysis revealed that the use of potentially inappropriate medications (PIMs) according to STOPP criteria and having six or more comorbidities were significantly associated with DRED_f.

Investigators concluded that around one in ten elderly ED visits were due to preventable DRPs, and the majority of these were associated with ADEs. PIM prescriptions and the presence of multiple comorbidities significantly increased the likelihood of preventable drug-related visits. These findings highlight the importance of careful medication management and comprehensive reviews to reduce preventable drug-related harm in elderly patients.

Source: bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01102-x