Understanding adverse drug-related emergency department visits: development of a conceptual model through a systematic review

Background: The burden of adverse drug event (ADE)-related emergency department (ED)visits is increasing despite several preventive measures. The objective of this paper was todevelop and validate a conceptual model for a better understanding of ADE-related ED visitsand to guide the design and implementation of effective interventions.Methods: The development of the model involved a systematic review of the literatureusing PubMed and Embase databases. Studies reporting the risk factors associatedwith ADE-related ED visits were included. The methodological qualities of the includedstudies were assessed using the Mixed Methods Appraisal Tool (MMAT). The model wasmapped and validated using face and content validity by an expert panel. Deficiencies andtargeted interventions were identified, and steps for the design and implementation wererecommended.Results: The literature search generated 1361 articles, of which 38 were included in thereview; 41 risk factors associated with ADE-related ED visits were identified. All factors weremapped, and the model was validated through face and content validity. The model consistedof six concepts related to sociodemographic factors, clinical factors, ADE-related to ED visits,ADE while in the ED, outcomes, and consequences. Interventions could be targeted at thefactors identified in each concept to prevent ADE-related ED burden.Conclusion: A conceptual model to guide the successful design and implementation ofstrategies to prevent ADE-related ED visits and the occurrence of ADE at ED was developed.Clinicians should take these factors into consideration to prevent untoward events, especiallywhen treating high-risk patients