The following is a summary of “Evaluating the Impact of a Discharge Pharmacy in the Emergency Department on Emergency Department Revisits and Admissions,” published in the May 2024 issue of Emergency Medicine by Chen, et al.

Nonadherence to medication can lead to adverse health outcomes, increased healthcare utilization, and higher overall healthcare costs. For a study, researchers sought to assess whether a discharge pharmacy in the Emergency Department (ED) was associated with decreased ED revisits and hospitalizations.

The cohort study analyzed data from electronic medical records of adult encounters at the University of Chicago Medicine between December 2019 and October 2021. Patients were categorized into five groups based on their prescription receipt: no medications prescribed, ED discharge pharmacy only, e-prescriptions to outside pharmacies, a combination of ED pharmacy and e-prescription elsewhere, and printed prescriptions with or without e-prescriptions. A total of 78,660 adult distinct encounters between December 2019 and November 2021 were included in the study. The ED pharmacy, located within the adult ED, exclusively served patients discharged from the ED. The primary endpoint was to evaluate if prescribing and dispensing medications solely from the ED pharmacy were associated with reduced ED revisits within 7 days and fewer hospitalizations within 30 days of the initial ED visit.

Compared to patients who received prescriptions only from the ED discharge pharmacy, those who received no prescriptions were 31.6% more likely to revisit the ED (P < 0.001), and those who received e-prescriptions sent to other pharmacies were 10.4% more likely to revisit (P = 0.017). Patients who received e-prescriptions from other pharmacies were 29.2% more likely to be hospitalized (P < 0.001), and those with a mixture of e-prescriptions were 59.5% more likely to be hospitalized (P < 0.001) compared to the ED pharmacy-only group.

Having a pharmacy in the ED for dispensing medications to discharged patients may reduce barriers such as cost, transportation, and pharmacy access, thus facilitating medication adherence and potentially decreasing the risk of repeat ED visits and subsequent hospital admissions.

Reference: sciencedirect.com/science/article/abs/pii/S0735675724000755