Medication-related adverse events account for an estimated 2 million Emergency Department (ED) visits annually in the United States. This study evaluated whether a pharmacist-led intervention could reduce ED return visits for medication-related events.

In this open-label, parallel-group randomized clinical trial, 330 adults were enrolled at a single university hospital in France between 2018 and 2021. Medication-related events were categorized as adverse drug events without misuse (e.g., drug reactions or interactions), adverse drug events with misuse, and nonadherence-related events.

Patients were randomized to a pharmacist-led transition-of-care intervention or usual care. In the intervention group, an ED pharmacist obtained a medication history and contacted the patient’s general practitioner and community pharmacist by phone and letter with details of the event and management recommendations; estimated intervention time was approximately 60 minutes per patient. Usual care included a medication history and a standard ED discharge letter to the general practitioner.

The primary outcome was ED return visits for the same medication-related adverse event within 6 months. Secondary outcomes included all-cause ED visits, outpatient visits, hospitalizations, and death.

The intervention group had a 19% reduction in ED return visits for medication-related adverse events attributed to the same medication as the initial ED visit, with similar reductions in all medication-related ED visits and hospitalizations. There were no significant differences in all-cause hospitalization or mortality between the intervention and control groups.

Notable barriers to implementation included the time-intensive nature of the intervention (approximately 60 minutes per patient) and the absence of a shared medical record to facilitate communication between ED and outpatient pharmacists and clinicians.

Key Takeaway: Improved communication between ED teams, outpatient physicians, and pharmacists may reduce recurrent ED visits for medication-related adverse events.

References

Villiet M, Laureau M, Perier D, et al. Emergency Department Visits for Medication-Related Events With vs Without Pharmacist Intervention: The URGEIM Randomized Clinical Trial. JAMA Intern Med. 2025;185(6):669–678. doi:10.1001/jamainternmed.2025.0640

Anderson TS. Secondary Prevention of Medication-Related Harms. JAMA Intern Med. 2025;185(6):679. doi:10.1001/jamainternmed.2025.0651