1
|
Eiden C, Laureau M, Richeval C, Arnal T, Ghomrani H, Peyrière H, Gaulier JM, Sebbane M. Acute cardiovascular disorders related to aphrodisiac honey ("Jaguar power") consumption: Warning of unintentional exposure to sildenafil. Rev Med Interne 2021; 43:68-69. [PMID: 34895766 DOI: 10.1016/j.revmed.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/23/2021] [Accepted: 10/10/2021] [Indexed: 11/30/2022]
Affiliation(s)
- C Eiden
- Service de Pharmacologie Médicale et Toxicologie, Hôpital Lapeyronie, 371, avenue du Doyen Gaston-Giraud, 34295 Montpellier cedex 5, France.
| | - M Laureau
- Département des Urgences adultes, Centre Hospitalier Universitaire, Montpellier, France
| | - C Richeval
- CHU Lille, Unité Fonctionnelle de Toxicologie, 59000 Lille, France
| | - T Arnal
- Département des Urgences adultes, Centre Hospitalier Universitaire, Montpellier, France
| | - H Ghomrani
- Département des Urgences adultes, Centre Hospitalier Universitaire, Montpellier, France
| | - H Peyrière
- Service de Pharmacologie Médicale et Toxicologie, Hôpital Lapeyronie, 371, avenue du Doyen Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - J-M Gaulier
- CHU Lille, Unité Fonctionnelle de Toxicologie, 59000 Lille, France
| | - M Sebbane
- Département des Urgences adultes, Centre Hospitalier Universitaire, Montpellier, France
| |
Collapse
|
2
|
Laureau M, Vuillot O, Gourhant V, Perier D, Pinzani V, Lohan L, Faucanie M, Macioce V, Marin G, Giraud I, Jalabert A, Villiet M, Castet-Nicolas A, Sebbane M, Breuker C. Adverse Drug Events Detected by Clinical Pharmacists in an Emergency Department: A Prospective Monocentric Observational Study. J Patient Saf 2021; 17:e1040-e1049. [PMID: 32175969 DOI: 10.1097/pts.0000000000000679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Adverse drug events (ADEs) are a major public health issue in hospitals. They are difficult to detect because of incomplete or unavailable medication history. In this study, we aimed to assess the rate and characteristics of ADEs identified by pharmacists in an emergency department (ED) to identify factors associated with ADEs. METHODS In this prospective observational study, we included consecutive adult patients presenting to the ED of a French 2600-bed tertiary care university hospital from November 2011 to April 2015. Clinical pharmacists conducted structured interviews and collected the medication history to detect ADEs (i.e., injuries resulting directly or indirectly from adverse drug reactions and noncompliance to medication prescriptions). Unsure ADE cases were reviewed by an expert committee. Relations between patient characteristics, type of ED visit, and ADE risk were analyzed using logistic regression. RESULTS Among the 8275 included patients, 1299 (15.7%) presented to the ED with an ADE. The major ADE symptoms were bleeding, endocrine problems, and neurologic disorders. Moreover, ADEs led to the ED visit, hospitalization, and death in 87%, 49.3%, and 2.2% of cases, respectively. Adverse drug event risk was independently associated with male sex, ED visit for neurological symptoms, visit to the ED critical care unit, or ED short stay hospitalization unit, use of blood, anti-infective, antineoplastic, and immunomodulating drugs. CONCLUSIONS This study improves the knowledge about ADE characteristics and on the patients at risk of ADE. This could help ED teams to better identify and manage ADEs and to improve treatment quality and safety.
Collapse
|
3
|
Breuker C, Faucanié M, Laureau M, Perier D, Pinzani V, Marin G, Sebbane M, Villiet M. Impact of a medico-pharmaceutical follow-up and an optimized communication between hospital and community on the readmission to the emergency department for an adverse drug event: URGEIM, study protocol for a randomized controlled trial. Trials 2021; 22:521. [PMID: 34362410 PMCID: PMC8349018 DOI: 10.1186/s13063-021-05501-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background Adverse drug events (ADE) represent one of the main causes of admission to emergency department (ED). Their detection, documentation, and reporting are essential to avoid readmission. We hypothesize that a pharmacist-initiated multidisciplinary transition of care program combining ED pharmacist contribution and medications’ data transfer between inpatient and outpatient caregivers will reduce emergency visits related to ADE Method/design This is a prospective, open-label, randomized controlled trial. The primary aim of the study is 6-month ED readmission related to the same ADE. Three hundred forty-six adult patients with an ADE detected by a binomial pharmacist-physician will be recruited from the ED of an University Hospital and will be randomized in two groups: [1] experimental group (multidisciplinary transition of care program and medications’ data transfer between inpatient and outpatient caregivers) and [2] control group (usual care). Patients will be followed up over a period of 6 months. Endpoints will be carried out blindly of the randomization arm. The primary endpoint is the rate of patients who had at least one readmission in the ED for the same reason at 6 months (data collected during a phone call with the patient and the general practitioner). Trials registered NCT03725046. Discussion The trial results will have implications for the role of the clinical pharmacist in an emergency department. If successful, the intervention could be considered for implementation across other hospitals. Trial registration ClinicalTrials.govNCT03725046. Registered on 30 October 2018
Collapse
Affiliation(s)
- Cyril Breuker
- CHU Montpellier, Clinical Pharmacy Departement, Univ. Montpellier, 34 295, Montpellier Cedex 5, France. .,PhyMedExp, Univ Montpellier, CNRS, INSERM, Montpellier, France.
| | - Marie Faucanié
- CHU Montpellier, Clinical Reasearch and Epidemiology Unit (Departement Information Médicale), Univ. Montpellier, 34 295, Montpellier Cedex 5, France
| | - Marion Laureau
- CHU Montpellier, Clinical Pharmacy Departement, Univ. Montpellier, 34 295, Montpellier Cedex 5, France.,CHU Montpellier, Emergency Medicine Department, Univ. Montpellier, 34 295, Montpellier Cedex 5, France
| | - Damien Perier
- CHU Montpellier, Emergency Medicine Department, Univ. Montpellier, 34 295, Montpellier Cedex 5, France
| | - Véronique Pinzani
- CHU Montpellier, Medical Pharmacology and Toxicology Department, Univ. Montpellier, 34 295, Montpellier Cedex 5, France
| | - Grégory Marin
- CHU Montpellier, Clinical Reasearch and Epidemiology Unit (Departement Information Médicale), Univ. Montpellier, 34 295, Montpellier Cedex 5, France
| | - Mustapha Sebbane
- CHU Montpellier, Emergency Medicine Department, Univ. Montpellier, 34 295, Montpellier Cedex 5, France
| | - M Villiet
- CHU Montpellier, Clinical Pharmacy Departement, Univ. Montpellier, 34 295, Montpellier Cedex 5, France
| |
Collapse
|
4
|
Lohan L, Marin G, Faucanie M, Laureau M, Macioce V, Perier D, Pinzani V, Giraud I, Castet-Nicolas A, Jalabert A, Villiet M, Sebbane M, Breuker C. Impact of medication characteristics and adverse drug events on hospital admission after an emergency department visit: Prospective cohort study. Int J Clin Pract 2021; 75:e14224. [PMID: 33866662 DOI: 10.1111/ijcp.14224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/12/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Emergency department (ED) overcrowding is a problem for the delivery of adequate and timely emergency care. To improve patient flow and the admission process, the quick prediction of a patient's need for admission is crucial. We aimed to investigate the variables associated with hospitalisation after an ED visit, with a particular focus on the variables related to medication. METHODS This prospective study was conducted from 2011 to 2018 in subacute medical ED of a French University Hospital. Specialised EDs (paediatric, gynaecologic, head and neck and psychiatric) and the outpatient unit of the ED were not included. Participation in this study was proposed to all adult patients who underwent a medication history interview with a pharmacist. Pharmacists conducted structured interviews for the completion of the medication history and the detection of adverse drug events (ADE). Relations between patient characteristics and hospitalisation were analysed using logistic regression. RESULTS Among the 14 511 included patients, 5972 (41.2%) were hospitalised including 69 deaths. In total, 7458 patients (51.4%) took more than 5 medications and 2846 patients (19.6%) had an ADE detected during the ED visit. In hospitalised patients, bleeding (32.2%) and metabolic disorders (16.8%) were the most observed ADE symptoms. Variables associated with increased hospital admission included 2 demographic variables (age, male gender), 4 clinical variables (renal and hepatic failures, alcohol addiction, ED visit for respiratory reason) and 6 medication-related variables (medications >5, use of blood, systemic anti-infective, metabolism and antineoplastic/immunomodulating medications and ADE). CONCLUSION We identified variables associated with hospitalisation including drug-related variables. These results point out the importance and the relevance of collecting medication data in a subacute medical ED (study registered on ClinicalTrials.gov, NCT03442010).
Collapse
Affiliation(s)
- Laura Lohan
- Clinical Pharmacy Department, CHU Montpellier, Univ Montpellier, Montpellier, France
- PhyMedExp, Univ Montpellier, CNRS, INSERM, Montpellier, France
| | - Gregory Marin
- Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Marie Faucanie
- Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Marion Laureau
- Clinical Pharmacy Department, CHU Montpellier, Univ Montpellier, Montpellier, France
- Emergency Medicine Department, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Valérie Macioce
- Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Damien Perier
- Emergency Medicine Department, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Veronique Pinzani
- Medical Pharmacology and Toxicology Department, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Isabelle Giraud
- Economic Evaluation Unit, Univ Montpellier, CHU Montpellier, Montpellier, France
| | - Audrey Castet-Nicolas
- Clinical Pharmacy Department, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Anne Jalabert
- Clinical Pharmacy Department, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Maxime Villiet
- Clinical Pharmacy Department, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Mustapha Sebbane
- Emergency Medicine Department, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Cyril Breuker
- Clinical Pharmacy Department, CHU Montpellier, Univ Montpellier, Montpellier, France
- PhyMedExp, Univ Montpellier, CNRS, INSERM, Montpellier, France
| |
Collapse
|
5
|
Serre A, Eiden C, Gourhant V, Laureau M, Perier D, Giraud I, Sebbane M, Peyrière H. [Involvement of addictovigilance in emergency department for the detection of abuse and dependence cases: 3 years of experience]. Therapie 2018; 73:501-509. [PMID: 30017376 DOI: 10.1016/j.therap.2018.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Due to the increase of hospitalization at emergency department (ED) related to psychoactive substances use (PSU), the addictovigilance center of Montpellier has been integrated into the URGEIM program for the detection of iatrogenic events at the ED. The objective of the present work was to analyze spontaneous reports (SR) collected via the URGEIM program. METHODS Analysis of spontaneous reports related to PSU at the ED of the Montpellier University Hospital, collected through the URGEIM program, between January 2014 and December 2016. RESULTS During the study period, 160 SR were collected through the URGEIM program on 1118 SR collected by the Addictovigilance center over the period: 40SR/342 in 2014, 46 SR/303 in 2015 and 74 SR/473 in 2016. Most patients were male (70%) and the mean age at admission was 33 years old. A total of 240 psychoactive substances were identified with 160 illicit substances (66.6%) [cocaine 38.1%, cannabis 30.6%] and 80 medications (33.3%) [buprenorphine 22.5%, benzodiazepines 20% and methadone 18.8%]. Mental and behavioral disorders (20.0%), general health problems associated with substance use (17.5%), cardiovascular diseases (13.1%) and infectious diseases (12.5%) were the main reported effects. The duration of emergency stay was inferior to 12hours in 63.1% of cases and greater than 24hours in 12.5% of cases. In 69.4% of cases, the event was considered as serious. The outcome was unknown for 6.9% of patients. CONCLUSION The number of SR from ED has increased over the study period, with the notification of serious and worrying cases, and the possibility of setting up actions. The deployment of addictovigilance within clinical services is a significant factor for notification and quality of care.
Collapse
Affiliation(s)
- Anaïs Serre
- Département de pharmacologie médicale et toxicologie, centre d'addictovigilance, hôpital Lapeyronie, centre hospitalier universitaire, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - Céline Eiden
- Département de pharmacologie médicale et toxicologie, centre d'addictovigilance, hôpital Lapeyronie, centre hospitalier universitaire, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - Vincent Gourhant
- Département des urgences, centre hospitalier universitaire, 34295 Montpellier, France
| | - Marion Laureau
- Département de pharmacie clinique et dispensation, pharmacie, centre hospitalier universitaire, 34295 Montpellier, France
| | - Damien Perier
- Département des urgences, centre hospitalier universitaire, 34295 Montpellier, France
| | - Isabelle Giraud
- Département des urgences, centre hospitalier universitaire, 34295 Montpellier, France
| | - Mustapha Sebbane
- Département des urgences, centre hospitalier universitaire, 34295 Montpellier, France
| | - Hélène Peyrière
- Département de pharmacologie médicale et toxicologie, centre d'addictovigilance, hôpital Lapeyronie, centre hospitalier universitaire, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
| |
Collapse
|