Emergency Department Models: EQUiPPED

In 2020, there were over 27 million emergency department (ED) visits by adults 65 years of age and older [1]. While older adults presenting to the ED are more likely to be admitted to the hospital than younger adults, the majority are discharged. In 2020 alone, more than 18 million ED visits by older adults (65%) were characterized as treat and release visits. High-intensity billing for treat and release ED visits has increased [2] indicating that patients who are discharged from the ED are more complex and likely to have multiple comorbidities. As with any transition, the transition from the ED to home or ED to a facility represents an opportunity for both medication reconciliation and medication-related adverse events. The ED discharge is unique in that it typically involves a provider other than the primary provider who may or may not have accurate information on the patient’s comorbidities and current medications, increasing the risk of medication-related adverse events. An ED-based study of patients 55 and older without cognitive impairment found that only one in five ED patients reported all of their medication accurately when compared to pharmacy-dispensing records [3]. In 2008, medication-related adverse events in older adults accounted for 18.5% of all ED treat and release medication-related adverse drug events [1], highlighting the importance of strategies to improve safe prescribing practices for older adults in this setting of care.