The full content of Annals is available to subscribers

Subscribe/Learn More  >
Academia and the Profession |

Potential Adverse Drug Interactions in the Emergency Room: An Issue in the Quality of Care

Mark H. Beers, MD; Michele Storrie, BS; and Genell Lee, RN, MSN
[+] Article, Author, and Disclosure Information

Grant Support: By the Charles A. Dana Foundation.

Requests for Reprints: Mark H. Beers, MD, UCLA, Center for Health Sciences, Department of Medicine, Division of Geriatric Medicine, Factor A-671, Los Angeles, CA 90024.

Current Author Addresses: Dr. Beers and Ms. Storrie: UCLA, Center for Health Sciences, Department of Medicine, Division of Geriatric Medicine, Factor A-671, Los Angeles, CA 90024.

Ms. Lee: UCLA, Center for Health Sciences, Nursing Director, Emergency Services, SPB 300, Los Angeles, CA 90024.

© 1990 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1990;112(1):61-64. doi:10.7326/0003-4819-112-1-61
Text Size: A A A

Study Objective: To determine how often emergency department physicians prescribe medications that can adversely interact with other medications that their patients are already taking, which patients are at highest risk for potential adverse reactions, and which medications most frequently lead to adverse interactions.

Design: Survey of elderly persons and other adults seeking care at an emergency department.

Patients: Four-hundred twenty-four randomly selected adults seeking care at a university-affiliated hospital emergency department.

Measurements and Main Results: We evaluated 424 randomly selected visits to a hospital emergency department made by 186 persons over age 65 and 238 younger adults; all of the subjects were discharged without hospital admission. Forty-seven percent of visits led to added medication, and in 10% of the visits in which at least one medication was added, a new medication added a potential adverse interaction. The interactions were determined by a computer program, were reviewed using explicit criteria, and were excluded if of uncertain or trivial clinical significance, rare, or not established for that specific drug. The number of medications used at presentation was the best predictor of whether a potential interaction would be introduced.

Conclusions: In the emergency departments studied, a medication history was recorded on every patient and was available to physicians, but physicians did not routinely screen for potential drug interactions. Further safeguards are needed to protect patients from receiving medications that could produce adverse interactions.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.