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Evaluation of an Emergency Department Over-the-Counter Analgesic Medication Starter Pack Initiative on 30-day
Sophia Sheikh1, Caterina Alacevich2, Magda Montague1
1Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida.
Background:
An Over-The-Counter (OTC) Starter Pack Initiative was implemented in the emergency department (ED) of a safety-net institution. Select OTC analgesic medications were dispensed free to patients experiencing financial/healthcare access barriers.
Study Objective:
We compared 30-day all-cause ED revisit rates in program participants before and after program participation.
Methods:
An institutional review board (IRB) approved retrospective observational study of ED visits made by program participants from 01/01 to 10/21/2021 was conducted. Demographics, number of ED visits, ICD-10 codes, and pain scores were collected. A modified patient fixed-effects Poisson regression estimated the relative risk of 30-day all-cause ED revisit after receiving assistance ("OTC-assisted") compared with the preprogram "usual care" risk.
Results:
There were 149 unique participants with both "usual care" and"OTC-program assisted" visits. Among these participants, the 30-day revisit rate was lower after program assistance (34%) compared to their revisit rate following a usual care visit (52%). OTC-Starter Pack program assistance was associated with a 20% reduction in the relative risk of revisiting the ED within 30 days (RR: 0.80, 95% CI: 0.71, 0.910) (p = 0.000). A cost saving analysis suggests that the program was associated with a per-patient saving of $53.21, on average, in avoided ED costs, net of the cost of the starter pack.
Conclusions:
The OTC-Starter Pack Program was associated with reduced 30-day revisit rates among patients with financial or healthcare access barriers and suggested cost savings within our study population.
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