A systematic review to evaluate the accuracy of electronic adverse drug event detection

Forster, Alan J.; Jennings, Alison; Chow, Claire; Leeder, Ciera; Walraven, Carl van

doi:10.1136/amiajnl-2011-000454

Cited by 44 publications

(56 citation statements)

References 49 publications

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“…27 Most likely, one of the principal structural factors that makes clinical and therapeutic follow-up of the patient difficult for the group of professionals who provide care is related to the availability and adequate use of responsive and uniform information systems for the different levels of care. 28,29 Therefore, using a single electronic medical record or reinforcing the training of professionals in the use of available information tools would be beneficial steps.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?

Poblador‐Plou²,

et al. 2012

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This study aims to analyse the influence of these factors (multimorbidity, polypharmacy, and multiple referrals) on the frequency of ADEs, as an indicator of therapeutic safety, in the context of a national healthcare system. METHODThis was a multicentre observational study of patients treated at seven urban primary care centres in Zaragoza, Spain. Selection of centres to participate in this study was conducted based on the following quality inclusion criteria: (a) centres with computerised records for all appointments Research Abstract BackgroundThe consequences of multimorbidity include polypharmacy and repeated referrals for specialised care, which may increase the risk of adverse drug events (ADEs).

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Section: Comparison With Existing Literaturementioning

confidence: 99%

Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?

Poblador‐Plou²,

et al. 2012

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“…[6] Although showed many advantages, including the ability to analyse routinely collected (low cost and readily available) data, this system has also barriers to overcome prior to achieve the goal as the standard ADEs detection method. [7] These barriers include the inconsistency of ADEs definition and the lack of ADEs standard nomenclature. [8] What makes the use of this method difficult is the fact that ADEs are usually contextdependent, that means that they are caused by disease-related and patient-related, rather than drug-related conditions.…”

Section: Introduction 11 Introduction On Using Information Technologmentioning

confidence: 99%

A methodology pathway to develop a Computer Drug Safety program in Primary health care setting based on clinical audit

Trtica

Guljaš

Šabanović

2015

JHA

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Objective: Medications management is an area in Primary health care (PHC) and General Practice (GP) setting where decision making is very important. Computer Decision Support program have been developed to help primary physicians in their decisions and have proved effective in improving the process of care and promising in economic issues. Methods: In order to create a Computer Drug Safety (CDS) program for managing oral anticoagulant therapy for use in PHC and GP setting with developed Information Technology (IT) System and established electronic Health Records (eHRs), we used clinical audit (a real-life practice analysis) as the methodology framework. We assumed that this method would enable a proposed CDS program to cope with clinical complexity of GP patients taking oral anticoagulants and also suggest this method as the operative framework for Quality of Care (QC) improvement and practice research. Results: By using clinical audit, we were able to identify the list of elements necessary for building up a feasible CDS program for a long-term oral anticoagulant therapy surveillance, for use in PHC and GP setting. According to this list of elements, we were able to create a paper based concept (a schemata) for this program development. This CDS program would not be a simple drug-dose calculator, but a comprehensive software support system integrated within the existing IT work applications. Conclusions: The main benefits, expected from this proposed CDS program, include: learning from work experience, oral anticoagulant QC improvement, better patients compliance to long-term treatment with the drug warfarin, practice performance follow up and practice research.

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“…20,[177][178][179] Early research found these tools to be very effective at detecting renal failure, diarrhoea and hypoglycaemia, but not as good as manual chart review at detecting symptom-related adverse medication events such as altered mental status.…”

Section: Trigger Toolsmentioning

confidence: 99%

“…181 Forster et al in 2011 undertook a systematic review to evaluate the accuracy of electronic tools in identifying AMEs, and found that detection rules were variable, definitions were variable, rules were often not validated against a "gold standard" and few of the detection algorithms considered clinical priorities. 179 Importantly, the review by Forster et al excluded research in the paediatric setting, however these limitations are also likely to exist with information systems used for ADE detection in paediatrics. 179 In contrast, automated adverse event detection was found to have positive effects on quality of care and cost-effectiveness by Lemon et al in the paediatric setting.…”

mentioning

confidence: 99%

“…179 Importantly, the review by Forster et al excluded research in the paediatric setting, however these limitations are also likely to exist with information systems used for ADE detection in paediatrics. 179 In contrast, automated adverse event detection was found to have positive effects on quality of care and cost-effectiveness by Lemon et al in the paediatric setting. 178 Manual chart review using the IHI sampling method has had more positive success.…”

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Advanced practice in paediatric pharmacy: What is it, how do you get there, and what does it mean for children?

Stacey¹

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The quality and safety of medicines use is as important in paediatrics as in adult medicine, and closely linked to the skills, knowledge, attitudes and behaviours of health professionals responsible for patient care. The aim of this research was to investigate advanced paediatric pharmacy practice; how to develop and assess advanced skills; and how these skills improve outcomes for children.Prevention of adverse medication events (AMEs) is the most researched pharmacy impact on patient outcomes. However, there is limited evidence in paediatrics. The first phase of this research investigated AMEs in children, with the hypothesis that: Voluntary reports of AMEs can be used to identify trends over time in response to safety improvement initiatives, and identify associated skills required of health practitioners.The first component of this phase reviewed six months of potential and actual AMEs identified from three databases: clinical incident reports, pharmacist intervention reports and administrative coding using the International Classification of Diseases 10 th Revision (ICD-10). Analysis identified 447 individual AMEs. Little duplication between data sources was found. ICD-10 coding identified the most cases of harm, and intervention and incident reports identified the most cases of error. ICD-10 events rarely involved error and were time-consuming to retrieve, hence this method was not used in subsequent research. The second phase of research tested the hypothesis that:iii Paediatric hospital pharmacists value formal recognition of advanced pharmacy practice, can describe the characteristics of advanced practitioners and identify preferred methods of assessment of advanced practice.Four focus groups, involving 31 Australian paediatric pharmacists, concluded that advanced practice should be formally recognised, and include a foundation in clinical practice, together with education, research and service improvement outside the institution. Multiple methods of assessment were recommended; most preferred were direct observation of practice, peer review and portfolio review. Knowledge of paediatric diseases and drug handling, and skills in communication with children and families, were important.The third phase of the project reviewed two existing datasets to test two hypotheses, the first of which was: Pharmacist interventions can document progression to advanced practice.Six hundred interventions recorded by four pharmacists from one paediatric hospital were retrospectively reviewed over three separate periods from 2005 to 2012. Skills demonstrated in these interventions were rated using a pilot scale from 1 to 5, representing skills typical of intern pharmacists through to advanced practice. Skills increased over time, with more Level 3-5 interventions recorded in the later time periods, and mean skill level increasing from 1.9 to 2.6 (p<0.01).The second hypothesis in this phase was: Training and development priorities in paediatric pharmacy can be identified by direct observation of pharmacists working ...

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A systematic review to evaluate the accuracy of electronic adverse drug event detection

Cited by 44 publications

References 49 publications

Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?

Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?

A methodology pathway to develop a Computer Drug Safety program in Primary health care setting based on clinical audit

Advanced practice in paediatric pharmacy: What is it, how do you get there, and what does it mean for children?

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