The Four Drug Classes Most Responsible for ED Visits Following Adverse Drug Events

The drug classes most frequently responsible for emergency department (ED) visits as the result of adverse drug events (ADEs)–anticoagulants, antibiotics, diabetes agents, and opioids—remained unchanged between 2005 and 2014, according to a November 22, 2016, original investigation in JAMA. The authors conducted an active, nationally representative, public health surveillance project on 42,585 cases in 58 EDs during 2013 and 2014. Based on the data, they estimated that four ED visits for an ADE occur annually for every 1,000 people in the United States. The most common ADEs were allergic reactions. Other common symptoms include bleeding after anticoagulant use and changes in mental status due to diabetes medications or opioids. Hospitalizations after visiting the ED for an ADE occurred 27.3% of the time. More than one-third (34.5%) of ED visits for ADEs occurred among adults age 65 or older, an increase of almost 10 percentage points from 2005-2006, when the number was 25.6%. Anticoagulants, antibiotics, and diabetes medications were the agents most commonly responsible for ED visits involving ADEs, accounting for 46.9% of visits. After the authors adjusted for frequency of prescribing, ED visits for these classes remained more frequent than visits for other drugs, even those commonly considered high risk.