Medications brought into the Emergency Department by Ambulance: Does this impact on the accuracy of prescribing on admission?

Abstract

Aims: We hypothesize that the accuracy of medication prescribing is improved when the patients’ own medications (POM) are brought to the Emergency Department (ED). We aimed to: • determine the frequency with which paramedics bring POM to ED, • compare the incidence of admission medication chart errors when POM are brought to the ED and when they are not. Methods: Patients were enrolled if they were adult, brought to ED by ambulance, taking four or more regular medications, admitted to hospital and not referred to a pharmacist prior to the admission medication chart being written. ED pharmacists determined patients’ regular medications and details of medications brought in by ambulance. Medication charts were assessed for discrepancies related to medications taken prior to presentation. These were recorded as errors if a change was made to the medication chart after a pharmacist’s discussion with the prescriber. Results: 100 patients were enrolled: mean age 71.8 ± 14.7 years, 63% were male, mean number of regular medications 8.0 ± 3.7. Paramedics brought all, some and none of a patient’s POM to ED in 30%, 37% and 33% of cases, respectively. Among the 428 POM brought to ED there were 56 (13.1%) prescribing errors on admission medication charts. Among the 372 POM not brought to the ED there were 95 (25.5%) prescribing errors – a highly significant difference (p < 0.001). Conclusion: When ambulance paramedics bring POM to ED for use by prescribers, significantly fewer prescribing errors occur on admission medication charts. An intervention encouraging paramedics to bring POM to ED is planned.