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Preventable adverse drug events: Descriptive epidemiology
Author(s) -
Woo Stephanie A.,
Cragg Amber,
Wickham Maeve E.,
Villanyi Diane,
Scheuermeyer Frank,
Hau Jeffrey P.,
Hohl Corinne M.
Publication year - 2020
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.14139
Subject(s) - medicine , adverse effect , observational study , pharmacovigilance , emergency medicine , drug , emergency department , epidemiology , logistic regression , diabetes mellitus , retrospective cohort study , intensive care medicine , pharmacology , psychiatry , endocrinology
Aim Our objective was to identify preventable adverse drug events and factors contributing to their development. Methods We performed a retrospective chart review combining data from three prospective multicentre observational studies that assessed emergency department patients for adverse drug events. A clinical pharmacist and physician independently reviewed the charts, extracted data and rated the preventability of each adverse drug event. A third reviewer adjudicated all discordant or uncertain cases. We calculated the proportion of adverse drug events that were deemed preventable, performed multivariable logistic regression to explore the characteristics of patients with preventable events, and identified contributing factors. Results We reviewed the records of 1 356 adverse drug events in 1 234 patients. Raters considered 869 (64.1%) of adverse drug events probably or definitely preventable. Patients with mental health diagnoses (OR 1.8; 95% CI 1.3–2.5) and diabetes (OR 1.7; 95% CI 1.2–2.4) were more likely to present with preventable events. The medications most commonly implicated in preventable events were warfarin (9.4%), hydrochlorothiazide (4.5%), furosemide (4.0%), insulin (3.9%) and acetylsalicylic acid (2.7%). Common contributing factors included inadequate patient instructions, monitoring and follow‐up, and reassessments after medication changes had been made. Conclusions Our study suggests that patients with mental health conditions and diabetes require close monitoring. Efforts to address the identified contributing factors are needed.