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  1. JJ Muller,
  2. R Mcnamara
  1. Emergency Medicine, Imperial College Healthcare NHS Trust, London, UK


Objectives & Background Adverse drug reactions represent a major burden on healthcare, causing between 3–5% of all hospital admissions.1 This impact is magnified in older patients; studies have shown that up to 51.3% of older patients were prescribed potentially inappropriate medications.1

These findings are highly relevant to Emergency Medicine with ever increasing emphasis being placed on attendance avoidance, and increasing numbers of older patients.

Methods We utilised the STOPP/START criteria2 and Anticholinergic burden scoring3 to assess the drug histories of all patients over the age of 65 who presented over the course of a year to a major London A+E department with three common presentations: bleeding, confusion and falls.

Results We found consistently high levels of potentially inappropriate prescribing with 64% of patients presenting post a fall, 92% with new confusion and 23% with bleeding, having drug histories that warranted a medications review. 22% of patients presenting after a fall also had clinically relevant anticholinergic scores and higher re-attendance rates than those with low anticholinergic scores.

Conclusion We designed a pilot study using a digital app designed by a Geriatrician to analyse and prompt potential medication changes for patients admitted to our Clinical Decision Unit with the aim of future attendance avoidance.

  • Trauma

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