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HOSPITAL AUTHORITY CONVENTION 2016  Service Enhancement Presentations

                                    F5.7  Healthcare Advances, Research and Innovations  09:00  Room 421

                                    Preventability of Drug Related Emergency Medical Ward (EMW) Admission of the Teaching Hospital of Hong

                                    Kong: Can We Prevent It?
                                    Wong KCV 1, Wan CK 2, Mok MY 3, Chan WK 2, Chan EWY4, Wong FFC 1, Wong CKI 5 Chui CMW 1, Tsui SH 2
                                    1Department of Pharmacy, Queen Mary Hospital, 2Department of Accident and Emergency, Queen Mary Hospital, 3Department
                                    of Medicine, The University of Hong Kong, Hong Kong, 4Department of Pharmacology and Pharmacy, The University of Hong
                                    Kong, Hong Kong, 5School of Pharmacy, University College of London, UK

                                    Introduction

                                    Medication Related Visits (MRVs) are a substantial cause of hospital admissions. However, little is known about the incidence,
                                    preventability and severity of MRVs resulting in emergency department visits in Hong Kong. To address this issue, we
                                    conducted a retrospective survey in the Emergency Medical Ward (EMW) of a teaching hospital in Hong Kong.

                                    Objectives

                                    Medication-related visit (MRV) is an event or circumstance involving drug therapy that actually or potentially interferes with
                                    the desired health outcome. The extent and characteristics of MRVs in the emergency department (ED) of Hong Kong are
                                    unknown. The aim of this study is to determine the MRVs epidemiology in a bustling ED in Hong Kong.

                                    Methods

                                    Patients were selected randomly from EMW during the one-month study period (01/09/2015 to 30/09/2015). Clinical Data
                                    Analysis and Reporting System (CDARS) was used to select fifteen beds daily at EMW on different time frames. Patients
                                    were eligible to be included if they were either transferred to EMW or admitted due to MRVs. All medical records were
                                    subsequently evaluated by one clinical pharmacist, one emergency physician and one medical physician independently to
                                    determine whether the visit was the result of a MRV.

                                    Results

                                    Among the 479 patients (mean age: 65.5 years; female to male ratio: 1.5:1) included in the study, the EMW visit was identified
                                    as medication related for 31 patients (6.5%); among them, 22 visits were deemed preventable. Severity was classified as
                                    mild in 27.3% of the 22 cases, and moderate in 72.7%. The most common reasons for medication related visits were non-
                                    adherence (39.3%), non-adverse drug reactions (27.9%) and use of wrong or suboptimal drug (11.5%). The most frequently
                                    incriminated drug classes were: (1) cardiovascular drugs (n = 15; 68.2%); (2) analgesics including NSAIDs (n =4; 18.2%) and (3)
                                    hypoglycemic agents (n = 2; 9.1%).

Wednesday, 4 May                    Conclusions

                                    A medication-related cause was estimated to be 31/ 479 (~ 1 in 15). The figure may even be higher for the minor MRV cases
                                    in daily EM visit that are not requiring EMW admission. MRVs leading to emergency department visits are frequent, and many
                                    are preventable, confirming that there is a need to develop prevention strategies. Medication review, medication monitoring
                                    and enhancing drug adherence strategies should be emphasized. Finally, further study with longer duration focusing on
                                    MRVs prior to patient transferal to EMW should be conducted.

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