Drug - related emergency department visits by elderly patients presenting with non-specific complaints

被引:59
作者
Nickel, Christian H. [1 ]
Ruedinger, Juliane M. [1 ]
Messmer, Anna S. [1 ]
Maile, Silke [1 ]
Peng, Arno [1 ]
Bodmer, Michael [1 ,2 ]
Kressig, Reto W. [3 ]
Kraehenbuehl, Stephan [2 ]
Bingisser, Roland [1 ]
机构
[1] Univ Basel Hosp, Dept Emergency Med, CH-4031 Basel, Switzerland
[2] Univ Basel Hosp, Dept Pharmacol & Toxicol, CH-4031 Basel, Switzerland
[3] Univ Basel Hosp, Dept Acute Geriatr, CH-4031 Basel, Switzerland
来源
SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE | 2013年 / 21卷
关键词
INAPPROPRIATE MEDICATION USE; SEVERITY INDEX; OLDER PERSONS; EVENTS; POLYPHARMACY; CRITERIA; RISK; OUTCOMES; PRESCRIPTIONS; ADMISSION;
D O I
10.1186/1757-7241-21-15
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Since drug-related emergency department (ED) visits are common among older adults, the objectives of our study were to identify the frequency of drug-related problems (DRPs) among patients presenting to the ED with non-specific complaints (NSC), such as generalized weakness and to evaluate responsible drug classes. Methods: Delayed type cross-sectional diagnostic study with a prospective 30 day follow-up in the ED of the University Hospital Basel, Switzerland. From May 2007 until April 2009, all non-trauma patients presenting to the ED with an Emergency Severity Index (ESI) of 2 or 3 were screened and included, if they presented with non-specific complaints. After having obtained complete 30-day follow-up, two outcome assessors reviewed all available information, judged whether the initial presentation was a DRP and compared their judgment with the initial ED diagnosis. Acute morbidity ("serious condition") was allocated to individual cases according to predefined criteria. Results: The study population consisted of 633 patients with NSC. Median age was 81 years (IQR 72/87), and the mean Charlson comorbidity index was 2.5 (IQR 1/4). DRPs were identified in 77 of the 633 cases (12.2%). At the initial assessment, only 40% of the DRPs were correctly identified. 64 of the 77 identified DRPs (83%) fulfilled the criteria "serious condition". Polypharmacy and certain drug classes (thiazides, antidepressants, benzodiazepines, anticonvulsants) were associated with DRPs. Conclusion: Elderly patients with non-specific complaints need to be screened systematically for drug-related problems.
引用
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页数:9
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