Prevalence of drug-related visits to the emergency department of King Chulalongkorn Memorial Hospital

Abstract

Problem/background : Drug-related problems (DRPs) are major causes of patient visits : to the emergency departments in several countries. However, there have not been sufficient publications on the prevalence and characteristics of this category of visits in Thailand.

Objective : To determine the prevalence and characteristics of drug-related : visits (DRVs) to the emergency department.

Design : Descriptive study.

Setting : Non-trauma Emergency Department, King Chulalongkorn Memorial Hospital.

Materials and Methods : This cross-sectional study was conducted at the Non-trauma : Emergency Department of King Chulalongkorn Memorial Hospital, affiliated with the Red Cross Society of Thailand and the Faculty of Medicine, Chulalongkorn University. All adult patients presenting to the Emergency Department during 7.30 a.m. and 3.30 p.m. over 4 months were evaluated. The emergency visits were identified as drug-related by a pharmacist and emergency physicians independently. DRPs were categorized according to Cipolle’s classification confirmed by external expert opinion. Preventability of DRPs was determined using Schumock and Thornton criteria.

Results : Of 1,000 patients, 369 patients (36.9%) were identified as having drug-related emergency department visits. Two hundred and fiftyfive visits (69.1%) were preventable. Two hundred patients (54.2%) needed hospitalization and two patients (0.5%>) died. The most common causes of DRVs were adverse drug reactions (32.52%), noncompliance (26.29%) and unnecessary drug therapy (14.36%). The most common drugs related to the emergency department visits were alcohol (5.53%o), furosemide (3.95%), aspirin (3.75%o), insulin (3.56%)) and metformin (3.36%o).

Conclusions : One-third of the patient visits at Non-trauma Emergency Department were drug-related. Two-thirds of these events were preventable.