Nearly 1 in 5 Emergency Department Prescriptions Yield Pharmacist Intervention

A targeted pharmacist review of “high-alert” medication prescriptions before patient discharge from the emergency department resulted in pharmacist intervention in 18.5% of such prescriptions, according to study results published online ahead of print in The American Journal of Emergency Medicine. 

“When necessary, emergency medicine pharmacists discussed recommendations with prescribers, or adjusted prescriptions according to institutional pharmacist privileges,” wrote authors from the Ohio State University Wexner Medical Center in Columbus. 

An earlier internal review involving a limited sample of emergency department discharge prescriptions found a 13.6% potential intervention rate by emergency medicine pharmacists, the authors explained. For the current study, researchers developed a real-time notification system within the electronic health record for a targeted discharge prescription review that included high-alert medications. The project took place over 12 weeks at a single emergency department in 2018. 

In all, 378 discharge prescriptions were reviewed by emergency medicine pharmacists, who identified medication-related problems with 158 of the prescriptions, according to the study. Among them, pharmacists intervened in 70 prescriptions, resulting in an 18.5% intervention rate.  

A change in medication dose/frequency, adjustment to prescription duration/refills, and patient education were the most common interventions provided by pharmacists, the retrospective review showed. Anticoagulant and anti-infective agents yielded the most interventions. 

“Utilization of a real-time notification system for prospective emergency department discharge prescription review is feasible,” the authors reported. 

They added that such a process, “using a real-time notification system within the electronic health record, identified opportunities for the pharmacist to ensure safe and optimal prescribing.” 

Reference:
Lineberry E, Rozycki E, Jordan TA, Mellett J, North AM. Implementation of pharmacist targeted discharge prescription review in an emergency department [published online ahead of print, 2021 May 1]. Am J Emerg Med. 2021;48:288-294. doi:10.1016/j.ajem.2021.04.054