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Medications and Emergency Department Discharge

June 20, 2023

Editor’s Note: Beth Dworetzky's son was born with a complex heart condition. She and her son navigated a fragmented health care system for 31 years until his death in October 2021. Beth recently retired from Family Voices, where her work focused on tools to assess family engagement in systems-changes to improve health care for all children and families. -Cara L. Coleman, JD, MPH, Associate Editor, Pediatrics

Family Connections with Pediatrics blog

Even when a child has an established doctor for regular care, they may still need urgent care in an emergency department (ED). They may leave the ED with medicine they need to take at home.

But, many families do not pick up the new medication.

A May 2023 report from the American Academy of Pediatrics, “Dispensing Medications at the Hospital Upon Discharge from an Emergency Department,” looks at ways to improve medication follow up after an ED visit (10.1542/peds.2023-062144).

What is the report about?

If a child is very sick, an ED might be the best place to get care as quickly as possible. Once the ED staff figure out the child’s health needs, they may order medications to:

  • Lessen pain
  • Prevent or cure an infection
  • Help with symptoms of an illness such as a rash or cough

Some medicines can be given in the ED, but others need to be taken for longer periods of time at home. One-third of families do not pick up medications after ED visits.1 And, fewer than 60% of teens pick up ordered medications for sexually transmitted infections (STIs).2

This report looks at ways to improve medication follow up after ED visits by:

  • Filling prescriptions in the ED
  • Explaining the medication and treatment plan using plain language or an interpreter in the family’s primary language
  • Reminding families to follow up with the child’s doctor in the community or their medical home3

How can families use this information?

  1. If your child has an order for medication in the ED, talk to the doctor about it before you leave. Do not be afraid to ask questions! You need to understand what the new medication is, how to take it, why your child needs it, and how it fits with the child’s plan of care.
  2. If you want to learn more about medications, read this report and ask your child’s doctor to teach you. For example, why are some medications liquid and others are pills? Does it matter? And what is the difference between strength and dose?
  3. If your child takes regular medications, carry a list of those with you, so the ED can be sure that any new medications will be okay to take with the others.
  4. If you are a part of an advisory committee or a community-based organization, partner with doctors to create plain language materials, such as infographics that have images and simple text, to help families understand more about medications.

References:

  1. Kajioka EH, Itoman EM, Li ML, Taira DA, Li GG, Yamamoto LG. Pediatric prescription pick-up rates after ED visits. Am J Emerg Med. 2005;23(4):454–458
  2. Goyal M, Hayes K, Mollen C. Sexually transmitted infection prevalence in symptomatic adolescent emergency department patients. Pediatr Emerg Care. 2012;28(12):1277–1280. DOI: 10.1097/PEC.0b013e3182767d7c
  3. Sia C, Tonniges TF, Osterhus E, Taba S. History of the medical home concept. Pediatrics. 2004 May;113(5 Suppl):1473-8. PMID: 15121914
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