How pharmacists can reduce emergency hospital visits

hospital pharmacist medication chart

A study has found more than a third of unnecessary emergency department visits for non-urgent health conditions could be managed by pharmacists

Researchers have conducted a cohort study looking at 34,550,020 unscheduled emergency department visits that occurred in Ontario, Canada, between 1 April 2010 to 31 March 2017.

Of these, 6,668,215 (19.3%) were visits related to a condition that could be managed by a general practitioner.

About 4.3 million were assigned a triage score of ‘less urgent’ or ‘non urgent’.

Potentially avoidable emergency department visits therefore represented 12.4% of all emergency department visits in Ontario.

Of all of potentially avoidable visits, more than one third (34.8%, n = 1,494,887) were visits that could be managed by pharmacists.

This represented 4.3% of all emergency department visits in Ontario during the study period.

The top 10 diagnoses represented 69.4% of all cases of avoidable and potentially pharmacist-manageable visits, and included acute pharyngitis, conjunctivitis, rash and other non-specific skin eruption, otitis externa, cough, acute sinusitis, other dermatitis, urticaria, and unspecific contact dermatitis.

Researchers concluded that about one-third of all avoidable emergency department visits may potentially be manageable by pharmacists if they can practise to the full scope that is available in other jurisdictions.

Previous studies have found similar estimates for pharmacist-manageable conditions.

However the authors say their study was “more comprehensive” than previous ones as it covered a large jurisdiction with a population of more than 14 million people and observation extending over seven years of follow-up.

“Providing optimal care to patients with noncritical minor ailments would help reduce emergency department overcrowding and avoid unnecessary exposure of non-urgent patients to the emergency department,” say the researchers.

“Pharmacists are regarded as the most accessible healthcare providers,” they say.

They add that in general, pharmacists welcome the opportunity to provide additional care to low-acuity patients and have been found to effectively do so in other jurisdictions.

Changes would be needed with expanded scope legislation to support this.

“Community pharmacist care for minor and low-acuity conditions can be provided with greater accessibility than emergency department-based care, and make a positive impact on overcrowding observed in emergency departments,” they conclude.

This study was published in the journal Research in Social and Administrative Pharmacy (login required)

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