Drug-related hospital admissions and emergency department visits: a feasibility study and an updated version of the AT-HARM10 assessment tool

Abstract Background: AT-HARM10 has been used as a research tool to identify drug-related hospital admissions. Its potential use to assess emergency department (ED) visits and an updated version of the tool have been requested.Aim: The aim of this study was to investigate the feasibility to identify drug-related ED visits with AT-HARM10 and provide an updated version of the tool.Method: A random sample of 400 patients aged 65 years or older from a clinical trial in four Swedish hospitals was selected. All patients’ ED visits within 12 months after discharge were assessed with AT-HARM10. The main outcome measures were the percentage of successfully assessed ED visits and the inter-rater reliability (IRR; Cohen’s kappa). AT-HARM10 was revised based on experience from its use in recent studies.Results: The patients had in total 184 ED visits, of which 179 (97%) were successfully assessed. Fifty-three ED visits (29%) were possibly drug-related. The Cohen’s kappa value was 0.70 (substantial). The instructions and one of the ten questions of AT-HARM10 were changed.Conclusion: It is feasible to identify possible drug-related ED visits in addition to hospital admissions in older patients with AT-HARM10 and the tool has been updated to support its use in clinical research.