Primary outcomes included return visits to the ED within 7 days. This study was approved by our institutions Institutional Review Board. The electronic medical record was queried using standard SQL queries for age, chief complaint, clinical impression, disposition, medications prescribed in the ED, home prescriptions and return visits within 7 days along with return chief complaint.
A control group included patients 65 or older with chief complaints of dizziness or vertigo who were discharged without any medications. The study group included patients who were either given meclizine in the ED or discharged with a home prescription. We excluded patients who were given a final diagnosis of central causes of vertigo, or who required admission to the hospital. Inclusion criteria included all patients age 65 years or older who presented to either ED with a chief complaint of dizziness or vertigo and were subsequently discharged from the ED. This was a retrospective observational study conducted at 2 tertiary care EDs between JDec 31, 2017. This retrospective study aims to determine the correlation between uses of meclizine and return visits to the ED within 1 week in patients older than 65 years old. The purpose of this study is to evaluate Emergency Department (ED) patients age 65 years old or older who received a prescription for meclizine during their ED stay. Despite existing recommendations, meclizine is still administered in this vulnerable age group, possibly due to a lack of safer alternatives. Although traditionally used for ambulatory care settings, Emergency Departments (ED) are starting to use the Beers criteria as a guide for ED prescribing. The American Geriatric Society (AGS) has placed meclizine on the Beers list of medications to avoid in patient over 65 years old because of the strong anticholinergic properties resulting in increased risk of confusion, falls/fractures, and overall mortality. Meclizine is one of the more commonly prescribed medications for patients discharged from the Emergency Department with a diagnosis of peripheral vertigo. Medications used to treat peripheral vertigo include antiemetics, antihistimines such as meclizine, or benzodiazepines. Vestibular suppressant medications are often used during the Emergency Department (ED) stay and administered as a discharge prescription to treat symptoms if peripheral etiology of vertigo is suspected. Not only is the evaluation of dizziness a diagnostic dilemma, the treatment modalities are limited especially in elderly patients. Ongoing dizziness was the most common reason for return visits there were no documented chief complaints of weakness, syncope/falls, or hypotension.ĭizziness and vertigo are common symptoms encountered by emergency physicians. Meclizine prescriptions at discharge were associated with fewer return visits to the ED within 1 week. Among the non-meclizine group, 102 patients (10.6%) had a return visit within 7 days.Ĭonclusion: There was no increase in return visits in elderly patients discharged from the ED with a prescription for meclizine after a diagnosis of benign dizziness. Patients who were given meclizine while in the ED without home prescriptions (121) had 16 return visits (13.2%). Of the meclizine patients, 548 (84.8%) were given home prescriptions, of which there were 36 (6.6%) return visits within 7 days.
#MECLIZINE FOR VERTIGO PLUS#
Results: There were a total of 1608 patients over 65 years of age who met inclusion criteria, 669 patients identified as receiving meclizine in the ED and 962 who received no meclizine (ED or ED plus home prescription). Charts were reviewed for diagnosis, prescriptions and return visits within 7 days. Inclusion criteria included patients > 65 years who were given meclizine in the ED or discharged with a prescription.
Methods: This is a retrospective observational study conducted at 2 urban tertiary care EDs over 5 years. Objectives: This study aims to determine the correlation between use of meclizine and return visits to the ED within 1 week in patients > 65 years old. Background: Meclizine is a commonly prescribed medication for patients discharged from the Emergency Department (ED) with a diagnosis of peripheral vertigo, however it is on the Beers list of medications to avoid in elderly patients.
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