Involvement of Pharmacists in the Emergency Department to Correct Errors in the Medication History and the Impact on Adverse Drug Event Detection

Clara Goulas; Laura Lohan; Marion Laureau; Damien Perier; Véronique Pinzani; Marie Faucanie; Valérie Macioce; Grégory Marin; Isabelle Giraud; Maxime Villiet; Mustapha Sebbane; Cyril Breuker

doi:10.3390/jcm12010376

Involvement of Pharmacists in the Emergency Department to Correct Errors in the Medication History and the Impact on Adverse Drug Event Detection

J Clin Med. 2023 Jan 3;12(1):376. doi: 10.3390/jcm12010376.

Authors

Clara Goulas¹, Laura Lohan^{1

2}, Marion Laureau¹, Damien Perier³, Véronique Pinzani⁴, Marie Faucanie⁵, Valérie Macioce⁵, Grégory Marin⁵, Isabelle Giraud⁶, Maxime Villiet¹, Mustapha Sebbane³, Cyril Breuker^{1

2}

Affiliations

¹ Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France.
² PhyMedExp, University of Montpellier, CNRS, INSERM, 34000 Montpellier, France.
³ Emergency Medicine Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France.
⁴ Medical Pharmacology and Toxicology Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France.
⁵ Clinical Research and Epidemiology Unit, CHU Montpellier, University of Montpellier, 34295 Montpellier, France.
⁶ Economic Evaluation Unit, CHU Montpellier, University of Montpellier, 34295 Montpellier, France.

Abstract

(1) Incomplete or wrong medication histories can lead to missed diagnoses of Adverse Drug Effects (ADEs). We aimed to evaluate pharmacist-identified ED errors in the medication histories obtained by physicians, and their consequences for ADE detection. (2) This prospective monocentric study was carried out in an ED of a university hospital. We included adult patients presenting with an ADE detected in the ED. The best possible medication histories collected by pharmacists were used to identify errors in the medication histories obtained by physicians. We described these errors, and identified those related to medications involved in ADEs. We also identified the ADEs that could not have been detected without the pharmacists' interventions. (3) Of 735 patients presenting with an ADE, 93.1% had at least one error on the medication list obtained by physicians. Of the 1047 medications involved in ADEs, 51.3% were associated with an error in the medication history. In total, 23.1% of the medications involved in ADEs were missing in the physicians' medication histories and were corrected by the pharmacists. (4) Medication histories obtained by ED physicians were often incomplete, and half the medications involved in ADEs were not identified, or were incorrectly characterized in the physicians' medication histories.

Keywords: adverse drug event; emergency department; medication history; pharmacist.

Grants and funding

This research received no external funding.