Medication-related negative outcomes in patients with permanent atrial fibrillation attended in a hospital emergency department

作者：Torres Degayon Virginia^*; Javier Montero Perez Francisco; Manuel Torres Murillo Jose; Jose Faus Dader Maria; Isabel Baena Parejo Maria; Angel Calleja Hernandez Miguel

来源：Emergencias, 2016, 28(2): 75-82.

• Permanent atrial fibrillation
• Emergency health services
• Pharmacotherapy, negative outcomes
• Pharma-

Objectives. To detect the frequency of negative outcomes associated with medication in patients with permanent atrial fibrillation (AF) who are attended in a hospital emergency department, and to assess type and severity of such outcomes related to AF medications as well as the rate of preventable negative outcomes.
Methods. Descriptive, observational cross-sectional study in patients with permanent AF who were attended in the emergency department of a tertiary care hospital during a 3-month period. A pharmacist interviewed the patients to record demographic characteristics, health problems, degree of functional impairment, and current drug treatments. An emergency physician and a pharmacist reviewed the patients' questionnaires and medical histories and evaluated them using the Dader method of pharmacotherapeutic follow-up.
Results. Of the 210 patients assessed, 198 entered the final analysis. They had a mean (SD) age of 80.5 (7.3) years, and 114 (57.5%) were women. One handred and thirty-four (67.7%) patients had medication-related negative outcomes; 61 (45.5%) of the outcomes were related to treatment for permanent AF. Twenty-four of these 61 patients (39.3%) had problems affecting safety; 36 (59%) of the problems were caused by drugs to control heart rate. Of the 73 patients with negative outcomes unrelated to AF medication, 34 (46.6%) were related to necessary medications and 38 (52.1%) were taking antibiotics. The frequencies of avoidable negative outcomes were significantly different between the group of patients with problems related to drug therapy for AF (where 55.7% were due to medications considered unnecessary) and those with problems unrelated to AF medications (where 78.1% were from avoidable medications) (P=.010). However, the level of seriousness was similar.
Conclusions. Nearly two-thirds of patients with permanent AF who come to the emergency department have a medication-related negative outcome that may or may not be related to AF treatment. Problems from drugs taken for reasons other than AF could more easily be avoided.

• 出版日期2016-4