PQ1: Drug-related hospital admissions – detection and prevention

ACPE UAN: 0475-0000-19-024-L04-P. A knowledge based activity.

Linked to EAHP Statements

Section 1 – Introductory Statements and Governance: Statement 1.1
Section 4 – Clinical Pharmacy Services: Statements 4.1, 4.2, 4.3, 4.4, 4.5
Section 5 – Patient Safety and Quality Assurance: Statements 5.1, 5.5, 5.7, 5.8

Abstract

Drug-related problems (DRPs) contribute to hospitalisation in up to 40% of older persons’ admissions. In most cases, this concerns adverse drug reactions (normal dose and overdose) but drug therapy failures (e.g. undertreatment) are also common. The fact that an admission is drug-related is often unrecognised and even when the causality is acknowledged, this is often not documented in the patient’s medical records. Hospital clinical pharmacists, with their extreme focus on medication are perhaps the most suitable professionals to detect drug-related admissions (DRAs) and can, thus, play an important role in the prevention of recurrent DRAs.

When determining the rate of DRAs, it’s unavoidable that it is a subjective measure and the results are often produced by experts who may have limited access to patient data. Also, the admissions can be divided into possibly, probably or certainly drug-related, with the medication in question contributing to a small or large extent to the admission.

Measures to prevent DRAs (and especially re-admissions) have been extensively tried and studied using medication reconciliation and reviews and follow-up phone calls to ensure correct medication management after discharge.

In this session, participants will be introduced to different alternative methods to detect DRAs, including new structured tools, and pros and cons will be discussed.

Examples of successful interventions to prevent drug-related readmissions will also be presented and discussed in plenum.

Learning objectives

After the seminar, participants should be able to:
• describe methods to detect DRAs and discuss their benefits and limitations;
• list various successful interventions to prevent DRAs.

Educational need addressed

To identify drug-related admissions is highly important and something that hospital pharmacists are well equipped to do. There is a need for higher awareness of this common problem and more efforts are needed to prevent unnecessary harm from medicines.

Keywords: drug-related admissions, medication harm, detection, prevention.