Preventing adverse effects of prescription medications

A 70 year old woman comes into the emergency department feeling weak, tired and dizzy–unable to cope at home alone. She is an adult onset diabetic, has high blood pressure, high cholesterol, and on 6 medications.

Her blood tests reveal that her kidney function is a little worse than before and her liver functions are not absolutely normal. None of this explains her extreme tiredness. She is admitted to hospital to look for infections and other subtle illnesses. After 3 days a pharmacology consult diagnoses that the problem is due to an interaction of 2 of her medications. These are changed and she quickly recovers and goes home.

The strategic initiative to identify patients at risk of adverse drug events will finalize a process to identify high risk patients so that physicians consider that cause quickly. This lady could have had the medications changed in the Emergency Department and gone home without the costs and inconvenience of a hospital stay.

It is estimated that 12% of emergency Department visits in British Columbia are attributable to the adverse effects of medications, and that emergency room physicians misdiagnose one half to one third of these cases, leading to inappropriate delays in diagnosis and treatment. Dr. Corinne Hohl, is leading the development of a new program which helps to identify adverse events related to prescription medications, reducing admissions to Hospital and prescribing best practices.