Understanding and Preventing Adverse Drug Events

Lindquist, Ruth; Gersema, Lisa M.

doi:10.1097/00044067-199802000-00012

Cited by 8 publications

(4 citation statements)

References 15 publications

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“…These 66 events which had caused 140 ALS are shown in Table 1. The three analysing physicians were yielded the following association between total score and causal relationship: 0-1 points equalled doubtful, [2][3][4] in agreement that these events were highly unlikely to In 12 out of the 18 ADRs (66%) no reaction by physicians was noticed ( Table 3). The suspected responsible drug was discontinued in three patients, an additional drug was ordered once and a laboratory investigation was have been caused by a drug, so that these events were not further evaluated.…”

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confidence: 85%

“…Thus, health care organisations must maintain ADR surveillance and prevention. At present, most Morbidity due to drugs is common in hospitalised patients although the rate is controversial and varies hospitals rely on spontaneous, voluntary reporting of ADRs by nurses and physicians, however, such systems between 0.7% and 35%, depending on the methods used [1][2][3][4][5][6][7][8]. In a recent meta-analysis of prospective studies the provide limited information [16].…”

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confidence: 99%

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Retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals

Tegeder

Muth‐Selbach

Oelkers

et al. 1999

Brit J Clinical Pharma

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Aims To estimate the frequency of adverse drug reactions (ADRs) identified through the use of automatic signals generated from laboratory data (ALS) in hospitalised patients. To determine the frequency of spontaneous recognition of these ADRs by the attending physicians and to assess the potential value of ALS for detection of ADRs.Methods Laboratory results of patients hospitalised in a nine bed medical ward were automatically recorded over a period of 17 months. Values exceeding defined boundaries were used as ALS. Charts of every third patient were analysed retrospectively with regard to adverse drug related reactions and causality was evaluated as well as whether the ADR had been recognised during the period of hospitalisation.Results The charts and ALS of 98 patients were analysed. In 18 cases a drug-related adverse reaction was probable. Awareness to the reaction by the treating physicians was evident in 6 out of these 18 ADRs. Approximately 80% of the ADRs were considered predictable. Three ADRs were regarded as serious. Conclusions Adverse drug reactions are common and often preventable. Only one third of ADRs which could have been detected through ALS were recognised by the attending physicians. An increased doctor's awareness of the frequency of drug related abnormal laboratory results by means of ALS is likely to increase the recognition rate of ADRs and might help to prevent them.Keywords: adverse drug reactions, automated laboratory signals stays and substantially add to health care expenditure Introduction [13][14][15]. Thus, health care organisations must maintain ADR surveillance and prevention. At present, most Morbidity due to drugs is common in hospitalised patients although the rate is controversial and varies hospitals rely on spontaneous, voluntary reporting of ADRs by nurses and physicians, however, such systems between 0.7% and 35%, depending on the methods used [1][2][3][4][5][6][7][8]. In a recent meta-analysis of prospective studies the provide limited information [16]. Moreover, physicians may not recognise ADRs even if the appropriate overall frequency of serious ADRs was 6.7% and that of fatal ADRs 0.32% of hospitalised patients [9]. information is in the patient's medical record [17, 18]. The diagnosis of ADRs, especially those that are not Approximately 2-6% of all hospital admissions per year are caused by ADRs [10][11][12]. ADRs can prolong hospital dose-related, is often difficult and agreement in clinical judgements is low (about 50%) both within and between physicians making diagnoses [19, 20]. As a result of this are the adverse reactions probability scale (APS) with 10

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confidence: 85%

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confidence: 99%

Retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals

Tegeder

Muth‐Selbach

Oelkers

et al. 1999

Brit J Clinical Pharma

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“…Eine Analyse der Verordnungsfehler zeigt, dass 31-58% dieser Fehler Dosierungsfehler sind [17,24,25].Besonders häufig werden Überdosierungen beobachtet,von denen 30-40% auf eine fehlende Dosisanpassung bei niereninsuffizenten Patienten und weitere 19% auf eine Nichtberück-sichtigung des Patientengewichts zurück-zuführen sind [25,26]. Daneben resultieren Dosierungsfehler aber auch aus Rechenfehlern.…”

Section: Verordnungsfehlerunclassified

Zur H�ufigkeit und Vermeidbarkeit von t�dlichen unerw�nschten Arzneimittelwirkungen

Schnurrer¹,

2003

Der Internist

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About every second decision of a medical doctor concerns drug therapy. On the basis of a representative Norwegian study, which analyzed fatal drug reactions in stationary patients of internal medicine wards by autopsy and plasma drug concentrations, in Germany 58,000 fatalities are occurring in this patient population. The treating physicians classified only 6% of drug induced fatalities as such. Therefore, the risk of drug therapy is grossly underestimated. In half of the cases medication errors were causative and therefore these could potentially all be avoided. In addition to improved pre- and postgraduate education in clinical pharmacology the use of computer-based expert systems would be a decisive step to optimize drug therapy.

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“…ADEs have been found to increase length of hospital stay by 1.7–2.2 days. 6,7 A meta-analysis of 39 prospective studies done in US hospitals estimated that ADEs had serious health implications in 6.7% of hospitalized patients and were fatal in 0.3%. 4 A summary analysis of 3 descriptive studies describing data on 1520 significant ADEs over 21 years found 15% of all ADEs to be life-threatening; 4% of these resulted in permanent disability and 8% ended fatally.…”

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Epidemiology, Comparative Methods of Detection, and Preventability of Adverse Drug Events

Al-Tajir

Kelly

2005

Ann Pharmacother

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Understanding and Preventing Adverse Drug Events

Cited by 8 publications

References 15 publications

Retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals

Retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals

Zur H�ufigkeit und Vermeidbarkeit von t�dlichen unerw�nschten Arzneimittelwirkungen

Epidemiology, Comparative Methods of Detection, and Preventability of Adverse Drug Events

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