Drug-related problems as reason for emergency department visit: 3 years of the FARM-URG registry

Abstract

Objectives: Drug-related problems (DRPs) are a well-known cause of emergency department (ED) visits. The objective of the FARM-URG project was to assess the prevalence of DRPs using an annual cross-sectional registry. Herein we report results of the first 3 years, indicating the prevalence of DRPs, drugs involved, and patient characteristics.

Methods: A point-prevalence multicenter study was conducted across EDs of hospitals in Spain. A specified day and hour was assigned to collect data from all adult patients attending the ED due to DRPs during three consecutive years. Medical records were retrospectively reviewed, with data recorded in REDCap.

Key findings: Overall, 4752 patients were evaluated at 32 centres, of which 366 (7.7%) visited the ED due to DRPs, with a prevalence ranging from 0 to 16.7%. Antithrombotic drugs accounted for the highest number of DRPs, responsible for 96 (26.8%) episodes. Falls (n = 29; 8.0%) were the most frequent DRPs, followed by haemorrhage (n = 26; 7.12%). Furthermore, 198 (54.2%) reported DRPs were unrelated to medication errors, 80 (21.2%) were overdose errors, and 40 (11.0%) were attributed to poor treatment adherence. Of 366 DRPs-related visits, 54 (14.8%) were due to inappropriately prescribed drugs according to the STOPP-START criteria. Overall, 86 (23.5%) patients revisited the ED within 30 days of discharge, with 34 (9.4%) returning to the ED for new DRPs.

Conclusions: DRPs are frequently responsible for ED visits and are associated with a considerable percentage of post-discharge visits. The goal of the FARM-URG project is to periodically gather data to design and implement preventive measures.

Keywords: adverse drug reactions; clinical pharmacy; elderly; emergency supply.