The pharmacoeconomics of managing acute agitation in the emergency department: what do we know and how do we approach it?

Abstract

The emergency department (ED) is commonly the first point of care for patients with acute behavioral issues from the community. Routinely, clinical management involves the use of benzodiazepine and/or antipsychotic drugs, when initial de-escalation strategies fail. There is currently scant literature available to inform the clinical management and resource utilization of acute agitation in the ED. This article discusses the approach to pharmacoeconomic studies of acute agitation management in the ED. It explores the conduct of such evaluations and highlights the cost and data sources required. The current difficulties experienced in conducting such evaluations are also discussed. Pharmacoeconomic studies related to the management of acute agitation in ED can be challenging. Robust clinical trials incorporating prospectively designed pharmacoeconomic studies will invariably contribute toward a better understanding of this therapeutic area and optimize the use of scarce resources.

Keywords::

• acute agitation
• behavioral disturbance
• benzodiazepines
• emergency
• sedation

Financial & competing interests disclosure

The authors express gratitude for research support for EW Chan received from the Ian Scott PhD scholarship, Australian Rotary Health and the Postgraduate Publication Award, Monash University, Victoria. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.