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Scand J Trauma Resusc Emerg Med. 2013 Mar 5;21:15. doi: 10.1186/1757-7241-21-15.

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

Author information

  • 1Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland. nickelc@uhbs.ch

Abstract

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.

PMID:
23497667
[PubMed - indexed for MEDLINE]
PMCID:
PMC3601989
Free PMC Article
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