Prevalence, Nature, Severity and Preventability of Adverse Drug Events in Mental Health Settings: Findings from the MedicAtion relateD harm in mEntal health hospitals (MADE) Study

Alshehri, Ghadah H.; Ashcroft, Darren M.; Nguyen, Joanne; Hann, Mark; Jones, Richard D.; Seaton, Kristof; Newton, Graham; Keers, Richard N.

doi:10.1007/s40264-021-01088-6

Cited by 7 publications

(16 citation statements)

References 41 publications

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“…Of the included studies, eight identified PRFs of PIP [ 43 – 50 ], seven of MEs [ 20 , 21 , 51 – 55 ], three of ADRs [ 17 , 50 , 56 ], two of MDs [ 57 , 58 ], one of ADEs [ 4 ], and two included a wider range of DRPs [ 59 , 60 ]. Sixteen studies were conducted in specialised mental health institutions/hospital trusts [ 4 , 20 , 21 , 45 , 47 – 49 , 51 – 54 , 56 – 60 ] whereas six studies were completed in psychiatry units from general hospitals [ 17 , 43 , 44 , 46 , 50 , 55 ]. The majority of the studies originated in Europe (19/22, 86.4%) [ 4 , 17 , 20 , 21 , 43 – 55 , 58 , 60 ], particularly in the UK ( n = 7/21, 33.3%) [ 4 , 20 , 21 , 52 – 54 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…Sixteen studies were conducted in specialised mental health institutions/hospital trusts [ 4 , 20 , 21 , 45 , 47 – 49 , 51 – 54 , 56 – 60 ] whereas six studies were completed in psychiatry units from general hospitals [ 17 , 43 , 44 , 46 , 50 , 55 ]. The majority of the studies originated in Europe (19/22, 86.4%) [ 4 , 17 , 20 , 21 , 43 – 55 , 58 , 60 ], particularly in the UK ( n = 7/21, 33.3%) [ 4 , 20 , 21 , 52 – 54 , 58 ]. The remaining studies were conducted in India ( n = 2/21, 9.5%%) [ 56 , 59 ] and the USA ( n = 1/21, 4.8%) [ 57 ].…”

Section: Resultsmentioning

confidence: 99%

“…All studies were observational except for one that was interventional [ 44 ]. Thirteen studies used a multivariable logistic regression alone [ 47 , 48 , 54 , 55 , 58 ] or a multivariable logistic regression preceded by a univariate regression [ 4 , 43 – 46 , 50 , 53 ] or bivariate regression [ 17 ] to test PRFs. Three studies were published between 2000 and 2010 [ 20 , 51 , 52 ] with 13 published between 2010 and 2020 [ 17 , 21 , 43 – 46 , 53 – 55 , 57 – 60 ] and six in 2021 [ 4 , 47 – 50 , 56 ].…”

Section: Resultsmentioning

confidence: 99%

“…Length of hospitalisation*, number of comorbidities, F1, F2 and F3 diagnosis*, F4, F6, F7 and other Pearson’s Chi-square test Seifert et al (2021) [ 50 ], Germany Three geriatric psychiatric wards of the district hospital with a clinic and polyclinic for psychiatry and psychotherapy at the university hospital P, CS IPs age ≥ 65 years who had inpatient stay of ≥1 week 14 months 330 PIM, ADR PIM: Age*, number of medications*, nursing home, total number of existing diagnoses, existence of various psychiatric and neurological diagnoses (mood disorder, schizophrenia*, dementia*, substance abuse/dependence, Parkinson’s disease), delirium/behavioural problems in dementia, (foreign) aggressiveness, delirium with and without dementia, diabetes mellitus, presence of at least any one cardiovascular or neurological diagnosis and total number of prehospital drugs prescribed ADR: Sex, age, total number of morbidities, number of medications*, PIP prescriptions*, presence of various psychiatric diagnoses (affective disorder, schizophrenia, dementia, substance abuse/dependence, somatoform disorder) and care in a nursing home Multivariable logistic regression Kanagaratnam et al (2014) [ 17 ], France Acute geriatric care unit specialising in the management of patients with dementia P, L IPs with dementia syndrome admitted for an unscheduled hospitalisation 19 months 293 ADR Sex, age, nursing home resident, polypharmacy (C5 medications per day), renal failure, MMSE score, neurological drugs*, cardiovascular drugs*, other drugs Multivariable logistic regression Dharman et al (2020) [ 56 ], India Mental Health Centre, Trivandrum Kerala P, CS IP 19 months 442 ADR Age, sex, diagnosis. Chi-square test Alshehri et al (2021) [ 4 ], UK Three mental health trusts in England: acute adult, later life, acute admission, intensive care, forensic, mother and baby, and rehabilitation wards R, CS IPs discharged from the hospital after being hospitalised ≥ 24 hours 12 months <...…”

Section: Resultsmentioning

confidence: 99%

“…A systematic review published in 2017 reported the rates of MEs and ADEs in psychiatric hospitals to be 10.6–17.5 and 10–42 per 1000 patient-days, respectively [ 3 ]. In a study published in 2021 originating from England, ADEs were reported to affect 12.6% of patients in mental health hospitals [ 4 ]. As DRPs may lead to patient morbidity and mortality [ 5 ], the World Health Organization (WHO) has launched its third Global Patient Safety Challenge on Medication Safety with a goal to reduce the incidence of preventable medication harm by half within 5 years [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Potential Risk Factors of Drug-Related Problems in Hospital-Based Mental Health Units: A Systematic Review

2022

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Introduction Reducing the occurrence of drug-related problems is a global health concern. In mental health hospitals, drug-related problems are common, leading to patient harm, and therefore understanding their potential risk factors is key for guiding future interventions designed to minimise their frequency. Objective The aim of this systematic review was to explore the potential risk factors of drug-related problems in mental health inpatient units. Methods Six databases were searched between 2000 and 2021 to identify studies that investigated the potential risk factors of drug-related problems in adults hospitalised in mental health inpatient units. Data extraction was performed by two authors independently and Allan and Barker’s criteria were used for study quality assessment. Studies were categorised based on drug-related problem types and potential risk factors were stratified as patient, medication, and hospital related. Results A total of 22 studies were included. Studies mostly originated in Europe ( n = 19/22, 86.4%), and used a multivariable logistic regression to identify potential risk factors ( n = 13, 59%). Frequently investigated factors were patient age ( n = 14/22), sex ( n = 14/22) and the number of prescribed medications ( n = 14/22). Of these, increasing the number of prescribed medications was the only factor consistently reported to be significantly associated with the occurrence of most types of drug-related problems ( n = 11/14). Conclusions A variety of patient, medication and hospital-related potential risk factors of drug-related problems in mental health inpatient units were identified. These factors could guide the development of interventions to reduce drug-related problems such as pharmaceutical screening tools to identify high-risk patients for timely interventions. Future studies could test a wider range of possible factors associated with drug-related problems using standardised approaches. Clinical Trial Registration PROSPERO: CRD42021279946.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Potential Risk Factors of Drug-Related Problems in Hospital-Based Mental Health Units: A Systematic Review

2022

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Characteristics and causes of reported clozapine-related medication errors: analysis of the Ministry of Health database in Saudi Arabia

AlAmri,

Alluwaymi,

Alghamdi

et al. 2024

Int J Clin Pharm

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Background Clozapine has shown great efficacy in treating treatment‐resistant schizophrenia, but it is associated with a variety of medication- related safety problems. Despite this, there remains a lack of research on medication errors (MEs) associated with its use. Aim To characterize the nature and contributory factors of clozapine-related MEs reported from government hospitals and primary care centres in Saudi Arabia (SA). Method A cross-sectional analysis was carried out on MEs related to clozapine use reported to the General Administration of Pharmaceutical Care at the Ministry of Health (MOH) in Saudi Arabia between 2018 and 2022. The data were analysed descriptively to examine the nature and contributory factors of MEs. Results A total of 1,165 MEs were reported. The majority of reported errors involved patients aged > 18 years old, with 72.2% ( n = 841) being male. The central region was found to report errors more frequently (32.3%, n = 376). Pharmacists were reported to detect errors most frequently (59.6%, n = 695). MEs most often occurred in the prescribing stage (77.8%, n = 906), with “missing prescription information” (30.1%, n = 351) being the most frequent finding. The most frequent contributing factor was the lack of policy (33.1%, n = 351). The majority of errors did not reach the patients (92.3%, n = 1,075), and those that did reach patients rarely resulted in harm (0.3%, n = 2). Conclusion This study identified areas for improvement which could expedite the development of remedial interventions to reduce the risk of errors. Supplementary Information The online version contains supplementary material available at 10.1007/s11096-024-01782-2.

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A Multi-method Exploratory Evaluation of a Service Designed to Improve Medication Safety for Patients with Monitored Dosage Systems Following Hospital Discharge

Alqenae,

Steinke,

Belither

et al. 2023

Drug Saf

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Background and Objective Medication safety problems are common post-hospital discharge, and an important global healthcare improvement target. The Transfers of Care Around Medicines (TCAM) service was launched by a National Health Service Trust in the North-West of England, initially focusing on patients with new or existing Monitored Dosage Systems (MDS). The TCAM service is designed to enable the prompt transfer of medication information, with referrals made by hospitals at discharge to a named community pharmacy. This study aimed to explore the utilisation and impact of the TCAM service on medication safety. Methods The evaluation included a descriptive analysis of 3033 anonymised patient referrals to 71 community pharmacies over a 1-year period alongside an assessment of the impact of the TCAM service on unintentional medication discrepancies and adverse drug events using a retrospective before-and-after study design. Impact data were collected across 18 general practices by 16 trained clinical pharmacists. Results Most patient referrals (70%, 2126/3033) were marked as ‘completed’ by community pharmacies, with 15% of completed referrals delayed beyond 30 days. Screening of 411 patient records by clinical pharmacists yielded no statistically significant difference in unintentional medication discrepancies or adverse drug event rates following TCAM implementation using a multivariable regression analysis (unintentional medication discrepancies adjusted odds ratio = 0.79 [95% confidence interval 0.44–1.44, p = 0.46]; and adverse drug events adjusted odds ratio = 1.19 [95% confidence interval 0.57–2.45, p = 0.63]), although there remained considerable uncertainty. Conclusions The TCAM service facilitated a number of community pharmacy services offered to patients with monitored dosage systems; but the impact of the intervention on unintentional medication discrepancies and adverse drug event rates post-hospital discharge for this patient group was uncertain. The results of this exploratory study can inform the ongoing implementation of the TCAM service at hospital discharge and highlight the need to understand service implementation in different contexts, which may influence its impact on medication safety. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-023-01342-z.

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Prevalence, Nature, Severity and Preventability of Adverse Drug Events in Mental Health Settings: Findings from the MedicAtion relateD harm in mEntal health hospitals (MADE) Study

Cited by 7 publications

References 41 publications

Potential Risk Factors of Drug-Related Problems in Hospital-Based Mental Health Units: A Systematic Review

Potential Risk Factors of Drug-Related Problems in Hospital-Based Mental Health Units: A Systematic Review

Characteristics and causes of reported clozapine-related medication errors: analysis of the Ministry of Health database in Saudi Arabia

A Multi-method Exploratory Evaluation of a Service Designed to Improve Medication Safety for Patients with Monitored Dosage Systems Following Hospital Discharge

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