{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:53:28Z","timestamp":1759334008461,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objective: Drug-related problems (DRPs) are a common, potentially avoidable cause of emergency department (ED) use. In December 2022, our hospital integrated a pharmacist-led intervention into routine ED practice. This intervention comprised medication optimization, adherence counseling, and coordinated hand-off to primary care. We quantified 30- and 90-day reconsultations after discharge and explored factors associated with DRP-related revisits. Methods: A retrospective cohort of adults (\u226518 years) who attended a tertiary ED (Barcelona, Spain). We included index DRP visits from 1 December 2022 to 30 June 2024. All received the bundle. Demographic, clinical, and pharmacotherapeutic data were extracted from the Catalan Shared Health Record; an independent committee classified revisits as a DRP or non-DRP. Predictors of 30-day DRP revisits were assessed with multivariable logistic regression. Results: Among 1247 patients (mean age 78.6 \u00b1 16.2 years; 59.2% women; and median nine drugs), 120 (9.6%) reconsulted the ED within 30 days, and 194 (15.5%) within 90 days for any cause. DRP-specific rates were 30.8% (37\/120) at 30 days and 26.3% (51\/194) at 90 days; 81% and 80% of these revisits, respectively, involved a recurrence of the same DRP. The most frequent index DRPs were constipation (14.2%), gastrointestinal bleeding (9.2%), hypertension (8.3%), seizures (8.3%) and hyponatraemia (6.7%). An age \u2265 80 years independently predicted fewer 30-day DRP revisits (OR 0.32; 95% CI 0.13\u20130.79); hypertension and cognitive impairment were not significant after adjustment. Conclusions: In this single-arm implementation cohort, overall, 30-day ED reconsultations were 9.6% and about one-third were DRP-related, predominantly recurrences, and chiefly gastrointestinal bleeding and seizures. These descriptive findings should be interpreted cautiously given potential survivorship bias and residual confounding; the apparently lower risk among patients aged \u2265 80 years is hypothesis-generating and may reflect geriatric care pathways and caregiver engagement. Targeted post-discharge monitoring for high-recurrence DRPs may help reduce avoidable ED use, and future evaluations should test this in quasi-experimental or randomized designs.<\/jats:p>","DOI":"10.3390\/jcm14196907","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T09:12:23Z","timestamp":1759223543000},"page":"6907","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergency Department Reconsultations After a Secondary Prevention Bundle for Medication-Related Problems: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Adri\u00e1n","family":"Plaza-D\u00edaz","sequence":"first","affiliation":[{"name":"Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret 167, 08025 Barcelona, Spain"},{"name":"Institut de Recerca Sant Pau (IR SANT PAU), Sat Quint\u00ed 77-79, 08041 Barcelona, Spain"},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0060-9142","authenticated-orcid":false,"given":"Ana","family":"Juanes-Borrego","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret 167, 08025 Barcelona, Spain"},{"name":"Institut de Recerca Sant Pau (IR SANT PAU), Sat Quint\u00ed 77-79, 08041 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Sanz-Lopez","sequence":"additional","affiliation":[{"name":"Emergency Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret 167, 08025 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Gonz\u00e1lez-Bueno","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Dos de Maig Consorci Sanitari Integral, 08025 Barcelona, Spain"},{"name":"Central Catalonia Chronicity Research Group (C3RG), University of Vic\u2014Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordi","family":"Fern\u00e1ndez-Morat\u00f3","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Consorci Sanitari de Terrassa, 08227 Terrassa, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2170-4694","authenticated-orcid":false,"given":"Milagros","family":"Garc\u00eda-Pel\u00e1ez","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital General de Granollers, 08402 Granollers, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0008-641X","authenticated-orcid":false,"given":"Jes\u00fas","family":"Ruiz-Ramos","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret 167, 08025 Barcelona, Spain"},{"name":"Institut de Recerca Sant Pau (IR SANT PAU), Sat Quint\u00ed 77-79, 08041 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1007\/s11739-022-02935-9","article-title":"Drug-related emergency department visits: Prevalence and risk factors","volume":"17","author":"Nymoen","year":"2022","journal-title":"Intern. 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