Perspectiva de género en problemas asociados a medicamentos de alto riesgo atendidos en urgencias

Objectives: To characterize medication-related problems resulting in emergency department attendance involving high-alert medications, paying particular attention to sex-related differences in the type of the problem and medication associated with it. Methods: Retrospective observational study (2021-2022) based on the medical history at discharge, including adult patients seeking emergency department due to medication-related problems as a primary or secondary diagnosis. Patient grouping was performed according to the class of medication implicated in the event, as defined by the reference list of high-alert drugs for chronic patients (HAMC list). Sociodemographic and clinical baseline variables were collected. To explore gender differences in the type of problem and drug involved, statistical analysis included binomial tests and binary logistic regression with odds ratio estimation. Results: Among the 1,611 adult patients admitted to the emergency department with adverse events associated with a medication problem, 1,028 (64%) involved a high-alert medication. Women with moderate- and high-risk comorbidity showed a significative greater incidence of medication-related problems. Gender differences were particularly notable for events associated with loop diuretics (136 women [70%] vs 57 men [30%], p = 0.000); antipsychotics (30 women [65%] vs 16 men [35%], p = 0.039); opioids (37 women [73%] vs 11 men [27%], p = 0.000] and digoxin (22 women [81%] vs 5 men [19%], p = 0.02). Women showed a trend toward higher odds of experiencing unintentional drug poisoning (OR = 2.5; 95% CI: 0.786-8.356; p = 0.119). In contrast, nonadherence to prescribed high-alert medications occurred with greater frequency in men (OR = 0.711, 95% CI: 0.473-1.070; p = 0.102). Conclusions: A considerable proportion of medication-related problems that lead to emergency room attendance involve high-risk medications, and the type of problem presented and the type of drug involved differ between sexes. Findings highlight that addressing gender differences, especially with regard to high-risk medicines, could be crucial in moving toward safer and more equitable healthcare.