MedStar Authors catalog › Details for: Medication Allergy and Adverse Drug Reaction Documentation Discrepancies in an Urban, Academic Emergency Department.
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Medication Allergy and Adverse Drug Reaction Documentation Discrepancies in an Urban, Academic Emergency Department.

by Kiechle, Eric; Zeymo, Alexander; DeGeorge, Lindsey M; Sauter, Diane A; Mazer-Amirshahi, Maryann.
Citation: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology. 2018 Jul 02.Journal: Journal of medical toxicology : official journal of the American College of Medical Toxicology.Published: 2018ISSN: 1556-9039.Full author list: Kiechle ES; McKenna CM; Carter H; Zeymo A; Gelfand BW; DeGeorge LM; Sauter DA; Mazer-Amirshahi M.UI/PMID: 29968185.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment(s): Emergency MedicineActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1007/s13181-018-0671-7 (Click here) Abbreviated citation: J Med Toxicol. 2018 Jul 02.Abstract: INTRODUCTION: Medication histories, including knowledge of allergies and adverse drug reactions (ADRs), are a nationally recognized quality measure. Medication histories in the emergency department (ED) are often inaccurate or incomplete. Our objective was to determine the prevalence and nature of medication allergy and ADR discrepancies in an urban ED.Abstract: METHODS: This was a prospective observational descriptive study, enrolling a convenience sample of adults over 7 months at a single academic urban ED. Trained personnel recorded patient demographics and number of daily medications. Patients listed any prior drug allergies or non-allergic ADRs. Following the ED encounter, the patients' self-reported allergies and ADRs were compared to the electronic medical record (EMR) to identify and describe discrepancies.Abstract: RESULTS: A sample of 1014 patients, predominantly black (81%), female (60%), and in the 18- to 59-year-old range (69%), was recruited. Most patients were taking at least one daily medication (74%). Three hundred fifteen patients reported at least one allergy (31%), and 252 (25%) at least one ADR. Four hundred sixteen patients (41%) had a discrepancy between their self-report of allergy or ADR and the EMR. Omissions were the most frequent discrepancy. Full descriptions of allergies or ADR were present in 18.4% of charts. Fifty-seven patients (5.6%) were administered a medication which could have interacted with a documented allergy or ADR; none of the allergy EMR records were updated to reflected this.Abstract: CONCLUSIONS: In this cross-sectional ED study, drug allergies and ADRs were both highly prevalent. There were significant discrepancies in documentation of allergies and ADRs between patient self-report and the EMR.

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