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PACU Literature Review #12. Initiation of a discharge pharmacy within a busy urban emergency department: The first year

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Fischer D, Patel A, Perotti A, Bastow S, Scarpelli D, Lamb M, Spiegel T, Colgan K, Celmins L. Initiation of a discharge pharmacy within a busy urban emergency department: The first year. Am J Health Syst Pharm. 2022 May 21

PMID: 35596266.


  • Discharge prescriptions represent an important aspect of care for patients seen in the emergency department (ED) setting and are used by providers to continue therapy for acute illness once patients leave the ED or to prevent future exacerbations of chronic conditions.


  • Pilot study of discharge pharmacy in a busy urban emergency department staffed by an emergency medicine clinical pharmacist.
  • The pharmacy began processing prescriptions on December 18, 2019, using a formulary aimed towards providing commonly prescribed and high-risk medications.
  • The pharmacy accepts insurance plans in addition to utilizing 340B Drug Pricing Program pricing to offer affordable medications to patients.


  • During the first year of operation 10,230 prescriptions were filled for 5,703 patients, representing 13% of all patients discharged during that time.
  • Of the prescriptions filled, 35.4% were for products considered high-risk medications, including epinephrine autoinjectors, insulin, and antibiotics.
  • Over 50% of these high-risk medications were provided to patients through reduced cash pricing.
  • Pharmacist interventions were made on 4.3% of prescriptions to address incorrect dosing, avoid use of inappropriate antibiotics, and recommend alternative therapies.


  • The implementation of a discharge pharmacy within the ED allowed over 5,700 patients to be discharged with medications and represents a potential solution to issues surrounding medication noncompliance.

Additional Readings

  • Zydb E, Courtney DM, Malik S, Schmidt MJ, Lyden AE. Impact of discharge anticoagulation education by emergency department pharmacists at a tertiary medical center. J Emerg Med. 2017;53(6):896-903.
  • Cesarz J, Steffenhagen AL, Svenson J, Hamedani AG. Emergency department discharge prescription interventions by emergency medicine pharmacists. Ann Emerg Med. 2013;61(2):209-214.
  • Anzan M, Alwhaibi M, Almetwazi M, Alhawassi TM. Prescribing errors and associated factors in discharge prescriptions in the emergency department: a prospective cross-sectional study. PLoS One. 2021;16(1):1-12.