Prevalence of Drug-Related Emergency Department Visits at a Teaching Hospital in Malaysia

• Published in: Drugs -- real world outcomes 2015, Vol.2 (4), p.387-395
• Main Authors: Jatau, Abubakar Ibrahim, Aung, Myat Moe Thwe, Kamauzaman, Tuan Hairulnizam Tuan, Rahman, Ab Fatah Ab
• Format: Article
• Language: English
• Subjects: Ambulatory care; Antidiabetics; Chronic illnesses; Disease; Drug dosages; Drug overdose; Drug therapy; Drug use; Emergency medical care; Internal Medicine; Medical referrals; Medicine; Medicine & Public Health; Original; Original Research Article; Patient admissions; Patient satisfaction; Patients; Pharmacology/Toxicology; Pharmacotherapy; Sociodemographics; Teaching hospitals; Variables
• ISSN: 2199-1154; 2198-9788
• DOI: 10.1007/s40801-015-0045-2

Background Data on the prevalence of adverse drug event (ADE)-related emergency department (ED) visits in developing countries are limited. Malaysia is located in South-East Asia, and, to our knowledge, no information exists on ADE-related ED visits. Objective The objective of this study was to determine the prevalence, preventability, severity, and outcome of drug-related ED visits. Methodology A cross-sectional study was conducted in consenting patients who visited the ED of Hospital Universiti Sains Malaysia over a 6-week period. The ED physician on duty determined whether or not the visit was drug related according to set criteria. Other relevant information was extracted from the patient’s medical folder by a clinical pharmacist. Results Of the 434 consenting patients, 133 (30.6 %; 95 % confidence interval [CI] 26–35 %) visits were determined to be ADE related; 55.5 % were considered preventable, 11.3 % possibly preventable, and 33.1 % not preventable. Severity was classed as mild in 1.5 %, moderate in 67.7 %, and severe in 30.8 %. The most common ADEs reported were drug therapeutic failure (55.6 %) and adverse drug reactions (32.3 %). The most frequently implicated drugs were antidiabetics ( n  = 31; 23.3 %), antihypertensives ( n  = 28; 21.1 %), antibiotics ( n  = 13; 9.8 %), and anti-asthmatics ( n  = 11; 8.3 %). A total of 93 patients (69.9 %) were admitted to the ED for observation, 25 (18.8 %) were discharged immediately after consultation, and 15 (11.3 %) were admitted to the ward through the ED. Conclusion The prevalence of ADE-related ED visits was high; more than one-half of the events were considered preventable and one-third was classed as severe. As such, preventive measures will minimize future occurrences and increase patient safety.