Drug-related emergency department visits in older patients: an applicability and reliability study of an existing assessment tool.

ABSTRACT

BACKGROUND: AT-HARM10 is a research tool to identify possible drug-related hospital admissions. It is unclear whether the tool can be applied to emergency department visits as well. AIM: The aim of this study was to investigate the applicability and reliability to identify drug-related emergency department visits in older patients with AT-HARM10. METHOD: A random sample of 400 patients aged 65 years or older from a clinical trial in four Swedish hospitals was selected. All patients' emergency department visits within 12 months after discharge were assessed with AT-HARM10. The main outcome measures were the percentage of successfully assessed visits for applicability and the interrater reliability (Cohen's kappa). RESULTS: Of the initial sample (n = 400), 113 patients [median age (interquartile range) 81 (76-88) years] had at least one emergency department visit within 12 months. The patients had in total 184 visits, of which 179 (97%) were successfully assessed. Fifty-three visits (29%) were possibly drug-related. The Cohen's kappa value was 0.70 (substantial). CONCLUSION: It seems applicable and reliable to identify possible drug-related emergency department visits in addition to hospital admissions in older patients with AT-HARM10. As a consequence, the tool has been updated to support its novel use in clinical research.