AAP supports 24/7 pharmacy in emergency departments

Important points:

• Chronic disease relapses or exacerbations are often due to under-medication or non-compliance.
• Having access to a 24/7 pharmacy within the emergency department could reduce the barrier.

The AAP said adding 24-hour pharmacies to U.S. hospital emergency departments could ease the challenge of getting prescriptions right away.

Technical report published in Pediatrics The AAP’s Pediatric Emergency Care Committee recognizes that timing, lack of transportation, language barriers, and health insurance issues may limit a family’s ability to fill prescriptions immediately after an emergency department visit. pointed out there is.

“Medical care provided in ED often prioritizes the timely administration of medications such as analgesics, antibiotics, bronchodilators and corticosteroids, and requires treatment of acute clinical symptoms.” write the researchers. “Prompt initiation and maintenance of therapy are key factors in achieving optimal therapeutic efficacy.”recur Exacerbations of chronic conditions (such as asthma, epilepsy and diabetes) are often due to under-medication or non-compliance,” they continued. “Emergency care is provided around the clock for him, so inadequate pharmacy services to dispense outpatient medications can be a major barrier to treatment.”

According to the authors, approximately one-third of patients did not obtain drugs from off-site pharmacies after being discharged from the acute care hospital. The authors cited a 2018 study that found an 88.5% compliance rate among patients with 24/7 retail pharmacy access in ED.

Among the advantages of 24-hour pharmacies, the authors said, are the ability to identify those who cannot pay immediately. Providing free compassionate care may provide patients with needed medications.

The authors also mentioned other potential solutions, such as electronic prescribing, which have been shown to reduce harm and reduce patient waiting times in pediatric care, but not to improve medication adherence. Not shown. They also suggested giving first doses of antibiotics in the emergency department to patients who can take tablets. This is effective in large hospitals, but not in small hospitals. Also, dispensing several days’ worth of medicine for the patient’s family gives them more time to write prescriptions at their local pharmacy, but capsules are more effective than suspensions.

The authors documented the burden of staffing 24-hour ambulatory pharmacies, insurance payments, economic advantages for hospitals over small local pharmacies, and most notably, prohibiting dispensing in states that: He pointed out that there are some barriers to dispensing home medications in ED, such as regulations on drug delivery. Massachusetts and Washington.

They also discussed the potential adverse effects of this act. Encourage visits to the ED Increase the financial expenditure of hospital pharmacies, not pediatricians’ offices, to slow the progression of ED.

“Where logistically, legally and economically possible, we will provide medicines more conveniently, reliably and closer to the patient by dispensing critical and necessary medicines from ED outpatient pharmacies if we choose to do so. can be done,” they wrote. “This practice provides additional opportunities for health care providers to emphasize medication instruction and its importance, including the use of materials for caregivers with low literacy, and provides additional opportunities for them to safely administer medications to children after they return home. It will make sure that the family understands what to do in the future.”

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