Annals of Emergency Medicine
Volume 55, Issue 6 , Pages 493-502.e4 , June 2010

Do Emergency Physicians Attribute Drug-Related Emergency Department Visits to Medication-Related Problems?

  • Corinne M. Hohl, MD, MHSc

      Affiliations

    • Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
    • Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
    • Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
    • Corresponding Author InformationAddress for correspondence: Corinne M. Hohl, MD, MHSc, Department of Emergency Medicine, Vancouver General Hospital, 855 West 12th Ave, Vancouver, BC, V5Z 1M9 Canada; 604-875-4205, Fax 604-875-5506
  • ,
  • Peter J. Zed, PharmD

      Affiliations

    • Department of Pharmacy, Queen Elizabeth II Health Sciences Centre, Capital Health, Halifax, Nova Scotia, Canada
    • Department of Emergency Medicine and College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
  • ,
  • Jeffrey R. Brubacher, MD, MSc

      Affiliations

    • Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
    • Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
    • Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
  • ,
  • Riyad B. Abu-Laban, MD, MHSc

      Affiliations

    • Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
    • Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
    • Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
  • ,
  • Peter S. Loewen, PharmD

      Affiliations

    • Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
    • Pharmacy Services, Vancouver Coastal Health-Providence Health Care, Vancouver, British Columbia, Canada
  • ,
  • Roy A. Purssell, MD

      Affiliations

    • Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
    • Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada

Received 16 February 2009 ,Revised 25 September 2009 ,Accepted 15 October 2009.

References 

  1. AVERT. United States AIDS cases and deaths by year. http://www.avert.org/usastaty.htmAccessed August 19, 2008
  2. US Census Bureau. US Census 2000. http://www.allcountries.org/uscensus/1036_motor_vehicle_deaths_by_state.htmlAccessed August 19, 2008
  3. Cardinez C, Cokkinides V, Wingo P, et al. Cancer Prevention & Early Detection Facts & Figures. Atlanta, GA: American Cancer Society; 2000;
  4. In:  Kohn LT,  Corrigan JM,  Donaldson MS editor. To Err Is Human: Building a Safer Health System. Washington, DC: National Academies Press; 2000;
  5. World Health Organization. International drug monitoring: the role of the hospital (Report of a WHO meeting). WHO Tech Rep Series. 1966;425:5–24
  6. Forster A, Asmis T, Clark H, et al. Ottawa Hospital Patient Safety Study: incidence and timing of adverse events in patients admitted to a Canadian teaching hospital. CMAJ. 2004;170:1235–1240
  7. Leape LL, Brennan TA, Laird N, et al. The nature of adverse events in hospitalized patients (Results of the Harvard Medical Practice Study II). N Engl J Med. 1991;324:377–384
  8. Safer healthcare now! Committee NS. http://www.saferhealthcarenow.ca/Accessed November 2, 2008
  9. Hepler CD. Regulating for outcomes as a systems response to the problem of drug-related morbidity. J Am Pharm Assoc. 2001;41:108–115
  10. Capuano A, Motola G, Russo F, et al. Adverse drug events in two emergency departments in Naples, Italy: an observational study. Pharmacol Res. 2004;50:631–636
  11. Hohl CM, Robitaille C, Lord V, et al. Emergency physician recognition of adverse drug-related events in elder patients presenting to an emergency department. Acad Emerg Med. 2005;12:197–205
  12. Malhotra S, Jain S, Pandhi P. Drug-related visits to the medical emergency department: a prospective study from India. Int J Clin Pharmacol Ther. 2001;39:12–18
  13. Schneitman-McIntire O, Farnen T, Gordon N, et al. Medication misadventures resulting in emergency department visits at an HMO medical center. Am J Health Syst Pharm. 1996;53:1416–1422
  14. Trifiro G, Calogero G, Ippolito FM, et al. Adverse drug events in emergency department population: a prospective Italian study. Pharmacoepidemiol Drug Saf. 2005;14:333–340
  15. Zed PJ, Abu-Laban RB, Balen RM, et al. Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study. CMAJ. 2008;178:1563–1569
  16. Nebeker J, Barach P, Samore M. Clarifying adverse drug events: a clinician's guide to terminology, documentation, and reporting. Ann Intern Med. 2004;140:795–801
  17. Kaboli PJ, Hoth AB, McClimon BJ, et al. Clinical pharmacists and inpatient medical care. Arch Intern Med. 2006;166:955–964
  18. Budnitz DS, Pollock DA, Mendelsohn AB, et al. Emergency department visits for outpatient adverse drug events: demonstration for a national surveillance system. Ann Emerg Med. 2005;45:197–206
  19. Budnitz DS, Pollock DA, Weidenbach KN, et al. National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006;296:1858–1866
  20. Nelson T, Budnitz D, Weidenbach K, et al. Assessing the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance Project: six sites, United States, January 1-June 15, 2004. MMWR Morb Mortal Wkly Rep. 2005;54:380–383
  21. Zhan C, Arispe I, Kelley E, et al. Ambulatory care visits for treating adverse drug effects in the United States, 1995-2001. Jt Comm J Qual Patient Saf. 2995;31:372-378.
  22. Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356:1255–1259
  23. Wu JYF, Leung WYS, Chang S, et al. Effectiveness of telephone counselling by a pharmacist in reducing mortality in patients receiving polypharmacy: randomised controlled trial. BMJ. 2006;333:522–528
  24. Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239–245
  25. Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356:1255–1259
  26. Lanctot KL, Naranjo CA. Comparison of the bayesian approach and a simple algorithm for assessment of adverse drug events. Clin Pharmacol Ther. 1995;58:692–698
  27. Hohl CM, Dankoff J, Colacone A, et al. Polypharmacy, adverse drug-related events, and potential adverse drug interactions in elderly patients presenting to an emergency department. Ann Emerg Med. 2001;38:666–671
  28. Hepler C, Strand L. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47:533–543
  29. Manos D, Petrie D, Beveridge R, et al. Inter-observer agreement using the Canadian Emergency Department Triage and Acuity Scale. CJEM. 2002;4:16–22
  30. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174
  31. Baena M, Faus M, Fajardo P, et al. Medicine-related problems resulting in emergency department visits. Eur J Clin Pharmacol. 2006;62:387–393
  32. Tafreshi M, Melby M, Kaback K, et al. Medication-related visits to the emergency department: a prospective study. Ann Pharmacother. 1999;33:1252–1257
  33. Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med. 2003;78:775–780

 Provide feedback on this article at the journal's Web site, www.annemergmed.com.

 Supervising editor: Lewis S. Nelson, MD

 Author contributions: All authors conceived and designed the study, and all authors obtained funding. CMH and PJZ supervised the conduct of the study, data collection, and data management. CMH provided statistical expertise and analyzed the data. CMH drafted the article, and all authors contributed to its editing. All authors take responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This work was supported by a grant from the Vancouver Coastal Health Research Institute In It for Life fund. Dr. Hohl was supported by a Mentored Clinician Scientist award from the Vancouver Coastal Health Research Institute. Dr. Abu-Laban was supported by a Clinical Scholar Award from the Michael Smith Foundation for Health Research.

 Publication date: Available online December 11, 2009.

 Reprints not available from the authors.

 Please see page 494 for the Editor's Capsule Summary of this article.

PII: S0196-0644(09)01648-5

doi: 10.1016/j.annemergmed.2009.10.008

Annals of Emergency Medicine
Volume 55, Issue 6 , Pages 493-502.e4 , June 2010