PS-100 Protocolised medication after discharge from an emergency department

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Abstract

Background

In order to improve the quality of assistance and to promote rational use of drugs in patients who come to the emergency department (ED), a new drug kit dispensation programme was launched.

Purpose

To assess the viability of the drug kit dispensation programme in ED patients after discharge. To analyse the impact on the prescription of these drugs.

Material and methods

A retrospective experimental observational study was conducted from June to December 2015. 5 kits (ibuprofen, omeprazole, metamizol, paracetamol and butylscopolamine) were dispensed for the most common diagnoses in ED, containing the right medication to treat them. The kits were properly identified, packed and contained written information. All dispensations were registered by the ED physician in charge through the computer tool Selene, and the kits were given to the patients together with the discharge report. The registered variables were: number of patients, number and type of dispensed kits, prescriptions given by the correspondent ED, direct costs, percentage difference in expenditure compared with previous year, bearing in mind the trend in the first semester of 2015.

Results

Over the period of this study, 4320 kits (710 omeprazole, 1620 ibuprofen, 930 metamizole, 820 paracetamol and 240 butylscopolamine) were dispensed. Only 20% of the dispensations were registered, and therefore it was impossible to monitor these patients and analyse the results. In terms of expenditure on prescriptions, there was a drop in paracetamol (5.17%), in metamizole (18.64%) and in ibuprofen (9.14%); and there was an increase in omeprazole (2.97%). Butylscopolamine was not taken into consideration due to its erratic fluctuation. The cost of the kits, passed on to the hospital pharmacy service, was €287.82 for paracetamol, €184.14 for metamizole, €112.32 for butylscopolamine, €70.30 for omeprazole and €335.34 for ibuprofen. The estimated potential savings were: €4743 for paracetamol, €1485 for metamizol, €139 for butylscopolamine, €4509 for omeprazole and €3133 for ibuprofen.

Conclusion

Medication kits after discharge can be a good strategy to ensure compliance with the treatment, to promote rational use of drugs and to reduce the costs in ED as far as traceability can be totally ensured.

Conclusion

No conflict of interest

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