Dr. Corinne Hohl, emergency physician at VGH and researcher with the Centre for Clinical Epidemiology and Evaluation at VCH & UBC
A Vancouver Coastal Health Emergency Department (ED) pilot project is showing it may reduce hospital length-of-stay for high-risk patients by nearly 5 per cent.
The project: Adverse Drug Event Screening Program – tests a new VCH developed clinical decision rule that identifies patients at high-risk for an adverse drug event (ADE) who should be assessed by a clinical pharmacist. An ADE is an unfavourable medical event related to the use of medications.
The research team, led by VGH based Dr. Corinne Hohl, has been studying adverse drug events in the emergency department since 2006.
The team has published key studies establishing:
- One in every nine patients presenting in the ED are due to medication-related issues, and that of these visits, 68 per cent are preventable. (CMAJ June 3, 2008).
- The most common causes of drug-related visits were adverse drug reactions, non-adherence to medication, and use of wrong or suboptimal drugs by patients.
- Patients presenting to the ED with adverse drug event are at 50 per cent greater risk of spending additional days in hospital and have a 20 per cent higher rate of outpatient care visits.
- Their cost of care is nearly double that of patients without adverse drug events (Annals of Emergency Medicine Feb 25, 2011)
- Emergency physicians did not attribute 40-50 per cent of ED presentations due to adverse drug events to medications (Annals of Emergency Medicine 2010, 55, 493-502).
Preliminary data also shows that the intervention may be associated with a reduction in hospital admissions, as medication-related problems are identified and resolved in the ED, allowing patients who would otherwise be admitted to go home.
Final data results will come available in the fall of 2013, but the early data is showing that this practice change is feasible, making this study and pilot project an excellent example of how original “made in BC” research is being implemented locally to improve patient health care and conserve health care resources.
For the full length story visit VCH Research at www.vchri.ca.
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