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

Nickel, Christian H; Ruedinger, Juliane M; Messmer, Anna S; Maile, Silke; Peng, Arno; Bodmer, Michael; Kressig, Reto W; Kraehenbuehl, Stephan; Bingisser, Roland (2013). Drug-related emergency department visits by elderly patients presenting with non-specific complaints. Scandinavian journal of trauma, resuscitation and emergency medicine, 21(15), p. 15. BioMed Central 10.1186/1757-7241-21-15

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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. TRIAL REGISTRATION ClinicalTrials.gov: NCT00920491.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Bodmer, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1757-7241

Publisher:

BioMed Central

Language:

English

Submitter:

Patricia Rajaonina

Date Deposited:

01 Apr 2014 09:31

Last Modified:

26 Jun 2016 01:50

Publisher DOI:

10.1186/1757-7241-21-15

PubMed ID:

23497667

BORIS DOI:

10.7892/boris.47413

URI:

https://boris.unibe.ch/id/eprint/47413

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