Drug Events Take Heavy Toll on Emergency Care
Adverse drug events (ADEs) are a drain on health care resources, and a new study suggests that patients who seek emergency care for ADEs require longer hospital stays and incur higher costs than other emergency patients.
Reporting online in the Annals of Emergency Medicine in February, researchers said that patients who present to the emergency department with ADEs are 50% more likely to require additional days in the hospital and incur twice the costs of other patients.
“These medication-related visits to the emergency department are common and costly, and nearly 70% of them are preventable,” said lead study author Corinne Hohl, MD, an emergency physician at Vancouver General Hospital and researcher at Vancouver Coastal Health and the University of British Columbia.
Dr. Hohl attributes a significant percentage of ADEs to medication-related errors that a pharmacist’s counsel could have prevented. “Some of these patients have misused medications, but quite a few are having side effects or aren’t taking their medications as directed,” she explained.
In addition to increasing costs and contributing to emergency department overcrowding, adverse drug events waste precious time. “Medication-related problems are not necessarily the first thing we look for in an emergency patient when we are trying to diagnose what is wrong,” said Dr. Hohl.
For the study, “Outcomes of Emergency Department Patients Presenting with Adverse Drug Events,” researchers followed 1000 emergency patients for 6 months, 12% of whom presented with an ADE. Researchers estimated that these patients could cost the system as much as $49 million annually.
In a news release on the findings, Dr. Hohl said she and colleagues are working on a screening tool that would help emergency physicians identify patients at high risk of ADEs based on their medication regimen. “We hope eventually to be able to prevent many of these events from happening in the first place,” she added.
HHS Releases Overhauled National Vaccine Plan
In February, the US Department of Health and Human Services (HHS) unveiled its ambitious 10-year strategy to improve access to the preventive benefits of vaccines for all Americans. The update is the first of its kind since the National Vaccine Plan’s creation in 1994.
The plan’s focus is broad, incorporating issues related to research and development, supply, financing, distribution, safety, global cooperation, and health consumer and provider education regarding vaccines and immunization. HHS officials hope to speed the development of new products and improve delivery methods for existing vaccines.
“Vaccines are a critical cornerstone of the public health system,” said Howard K. Koh, MD, MPH, assistant secretary for health at HHS. “The National Vaccine Plan articulates a vision that will ensure that the nation’s prevention strategies protect the public for the next decade and beyond.”
The final plan reflects a collaborative effort by public health and medical experts, government officials, and the public to define the current state and future direction of immunization in the United States. HHS will continue to rely on these stakeholders to help implement the plan, said Bruce Gellin, MD, MPH, director of the National Vaccine Program Office and deputy assistant secretary.
“The plan is national in scope,” he said. “Implementation will require a well-organized effort among stakeholders, including federal, state, and local policymakers, health care providers, manufacturers, academia, philanthropic organizations, and the public.”
Just weeks after the plan was released, HHS announced that it had awarded contracts totaling $215 million to 2 companies, Novavax Inc and VaxInnate Inc, that are involved in developing new types of vaccines for influenza outbreaks and pandemics.
Online Drug Information Lags Behind FDA Action
The FDA recall of more than 500 unapproved prescription cough and cold medications in early March may prompt questions from patients in the coming months. The recalled medicines left a trail of misleading online information in their wake that could confuse consumers, industry blogger Ed Silverman reported.
Citing concerns about their unproven safety and efficacy, FDA ordered drug makers to stop making the products within 90 days and discontinue shipping within 180 days. “Unfortunately,” Silverman wrote, “someone forgot to tell the National Institutes of Health (NIH).”
Days after the drugs were recalled, NIH’s PubMed Health site was still instructing consumers on how to use the medicines. The information was provided by the American Society of Health-System Pharmacists, and had not been updated to reflect the recall.
Examples include guaifenesin, indicated for the treatment of chest congestion, and brompheniramine, an allergy medication, Silverman noted. The drug pages have since been revised, but the incident is a stark reminder of the fragmented state of online health data—even when it is provided as a service to consumers by the federal government.
Pharmacists can review a list of the recalled medications at http://phrmcyt.ms/h5xW9z and should be prepared to address patients’ questions and concerns regarding the recall. PT