{
  "abstract": "Background and Importance Drug-related problems (DRPs), including adverse events and medication errors, are responsible for about 15% of all hospital admissions. In addition to patient harm, DRPs can lead to high costs for healthcare systems. Despite various evidence supporting the role of clinical pharmacists in identifying DRPs, prospective analyses in emergency departments (EDs) remain scarce.Aim and Objectives We aimed to identify DRPs that potentially contributed to emergency hospitalisations and characterise them eg, according to their cause, severity, and preventability.Material and Methods This prospective evaluation was conducted in the ED of a tertiary hospital between April 1 and July 31, 2025. Four experienced clinical pharmacists performed type 2b medication reviews for patients who were hospitalised for ≥1 day. Patients directly admitted to intensive care units were excluded. Severity of DRPs was assessed using the National-Coordinating-Council-for-Medication-Error-Reporting-and-Prevention-index (NCC-MERP). DRPs that potentially caused the hospitalisation were classified according to their cause, involved medications, acceptance of clinical pharmaceutical interventions, causality (World-Health-Organisation-Uppsala-Monitoring-Centre), and preventability (Hallas 1993) after reaching internal consensus.Results Within 49 visits, clinical pharmacists reviewed the medication of 538 patients. In total, 418 DRPs were detected (mean 0.8 per patient). The majority of DRPs (69.1%, 289/418) were found reaching the patient without having caused harm (NCC-MERP C-D). Sixty-four DRPs were detected that potentially caused the hospital admission in 9.5% (51/538) of all patients. Thereof, main causes were ‘adverse events’ (26), ‘incompliance with guidelines’ (10), and ‘overdoses’ (9). Most frequently involved drug classes involved were ‘antithrombotic agents’, ‘psycholeptics’, ‘psychoanaleptics’, and ‘diuretics’. In 75% (48/64) of DRPs, clinical pharmaceutical interventions were considered by ED-physicians. Thirty-six of these DRPs were rated as ‘certain’ or ‘probable’, and 15 as ‘definitely preventable’.Conclusion and Relevance Approximately 1 out of 10 emergency hospital admissions was potentially caused by DRPs. Strengths of our analysis include its prospective design and implementation in clinical routine by multiple pharmacists. Our results are in line with existing evidence, thereby indicating external validity. We anticipate even higher numbers of DRPs, as we performed type 2b medication reviews only and intensive care patients were not included. Clinical pharmacists play an essential role in identifying DRPs and should be regularly integrated within interprofessional ED-teams to optimise medication safety.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Clinic Floridsdorf – Vienna Healthcare Group, Pharmacy Department, Vienna, Austria"
      ],
      "name": "L Cuba"
    },
    {
      "affiliations": [
        "Clinic Floridsdorf – Vienna Healthcare Group, Pharmacy Department, Vienna, Austria"
      ],
      "name": "V Palme"
    },
    {
      "affiliations": [
        "Clinic Floridsdorf – Vienna Healthcare Group, Pharmacy Department, Vienna, Austria"
      ],
      "name": "C Rauber"
    },
    {
      "affiliations": [
        "Clinic Floridsdorf – Vienna Healthcare Group, Pharmacy Department, Vienna, Austria"
      ],
      "name": "C Sanlioglu"
    },
    {
      "affiliations": [
        "Clinic Floridsdorf – Vienna Healthcare Group, Emergency Department, Vienna, Austria"
      ],
      "name": "P Eisenburger"
    },
    {
      "affiliations": [
        "Clinic Floridsdorf – Vienna Healthcare Group, Pharmacy Department, Vienna, Austria"
      ],
      "name": "A Zwiefler"
    }
  ],
  "title": "4CPS-075 Medication matters! Clinical pharmacists identify drug-related causes of emergency hospitalisations",
  "uid": "749f08be-e750-5cb9-b284-b53b4d147468"
}