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Emergency department medication and drug interaction evaluation
D Hancock1, J M Kennington, R R Beckner
1Barnes Hospital, St. Louis, MO 63110.
Hospital Pharmacy
|February 1, 1992
Summary
Emergency department medication histories are often incomplete in older adults, increasing the risk of potential drug interactions when new prescriptions are given. Improving medication reconciliation is crucial for patient safety.
Area of Science:
- Geriatric Medicine
- Clinical Pharmacy
- Emergency Medicine
Background:
- Accurate medication history is vital for safe patient care, especially in older adults with polypharmacy.
- Emergency department (ED) visits present unique challenges for obtaining comprehensive medication histories.
- Potential drug interactions pose a significant risk to elderly patients.
Purpose of the Study:
- To assess the accuracy of oral medication histories obtained upon ED arrival for patients aged 65 and older.
- To determine the frequency of potentially significant drug interactions resulting from ED prescriptions combined with patients' current medications.
Main Methods:
- Retrospective analysis of 228 ED visits for patients aged 65+.
- Data collection included patient-reported medication history and newly prescribed ED medications.
- Comparison of reported vs. 'forgotten' medications and identification of potential drug-drug interactions.
Main Results:
- Only 50.4% of patients provided a complete medication history.
- Patients 'forgot' an average of 1.3 medications.
- A potentially significant drug interaction rate of 3.4% was observed for patients receiving new ED prescriptions.
Conclusions:
- Incomplete medication histories are common in older adults presenting to the ED.
- Increased number of current medications correlates with a higher likelihood of an incomplete history.
- A notable percentage of ED prescriptions for older adults may lead to potentially harmful drug interactions.