The Pharmaceutical Journal
Vol 270 No 7240 p359
15 March 2003

This article
Reprint
Photocopy

News summary

Related websites
Journal of Clinical Pharmacy and Therapeutics abstract (more)

Drug-related problems may bring thousands to A&E departments

Drug-related problems may bring 3,000 patients each year to a hospital's accident and emergency (A&E) department, a new study indicates.

Researchers from Guy's and St Thomas' Hospital NHS Trust, London, have carried out what they say is the first UK study to review medication-related attendance at A&E.

They reviewed attendance over two weeks at their hospital's A&E department. Out of 2,636 patients, 106 (4 per cent) attended with a drug-related problem.

The most commonly presented problems were adverse drug reactions or side effects and overdoses (see Table below).

The agents most commonly associated with adverse reactions were analgesics, psychiatric drugs, drugs with narrow therapeutic indices, antibiotics, antihypertensives and illegal drugs. Around a third of the patients with side effects had taken illegal drugs.

Overdoses accounted for 27 per cent of medication-related problems. Half of these were intentional with the most frequently used drug being paracetamol. Of the 14 patients who presented because they had run out of medicines, six required an inhaler for asthma. Of the 20 patients with an "untreated indication", 11 had required emergency hormonal contraception. The four non-compliant patients were all taking medicines for psychiatric illness.

Patients with drug-related problems were more likely to present in the early hours of the morning and on Saturdays. The demographics of the patient group showed a younger age than reported in previous American studies, which the researchers attributed to increased use of illicit drugs (Journal of Clinical Pharmacy and Therapeutics 2003;28:41).

The study's lead author, Ruth Bednall, senior pharmacist in general medicine at the trust, told The Journal that advice from pharmacists could prevent the attendance of some patients at A&E. "With a decrease in A&E waiting times a priority for the health service, anything to reduce numbers has to be good," she said.