Adding medications in the emergency department: Effect on knowledge of medications in older adults

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Introduction: Older adults constitute 20% of the ED population. Of older patients discharged from the emergency department, 40% receive at least one new medication to add to their already complex medication regimen. The purpose of this study was to determine the effect of increasing medication complexity on knowledge of newly prescribed medications for older adults discharged from the emergency department. Methods: The complexity of self-administered medications after ED treatment was measured with the Medication Complexity Index to determine its potential influence on the patient’s knowledge of medication. The Knowledge of Medication Subtest, a measure of the effectiveness of medication teaching, was administered by telephone interview 48 to 72 hours after ED discharge. Results: Sixty rural ED patients ranging in age from 60 to 98 years completed the study. Higher medication complexity after the addition of medications in the emergency department was associated with less knowledge of their medications ( r = 0.37, P = .004). Discussion: The increase in medication complexity that results from ED therapeutic intervention may decrease knowledge of medications. A heightened emphasis should be placed on effective medication teaching, counseling, and follow-up for older adult ED patients. (J Emerg Nurs 1999;25:178-82)