Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study

Hohl, Corinne M.; Small, Serena S; Peddie, David; Badke, Katherin; Bailey, Chantelle; Balka, Ellen

doi:10.2196/publichealth.9282

Cited by 61 publications

(78 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Only 181 new cases per 100,000 due to AEMT were reported in the African region, compared to over 1,160 per 100,000 reported in the Americas. However, earlier reports suggest that these numbers may be underestimated because of non-reporting of new cases of AEMT [21]. In addition, the forecasted incidence in the African region is the lowest across all regions globally for 2020, 2030, and 2040.…”

Section: Discussionmentioning

confidence: 95%

Global Incidence and Mortality Trends due to Adverse Effects of Medical Treatment, 1990–2017: A Systematic Analysis from the Global Burden of Diseases, Injuries and Risk Factors Study

Nauman¹,

Soteriades²,

Hashim³

et al. 2020

Cureus

View full text Add to dashboard Cite

To quantify the global incidence and mortality of adverse effects of medical treatment (AEMT) and forecast the possible emerging trends of AEMT. Materials and methods We analyzed the latest data from the Global Burden of Disease (GBD) 2017 study. We describe the burden of AEMT based on age-and region-specific incidence and mortality rates between 1990 and 2017. Additionally, we evaluated the change of burden due to AEMT by different periods between 1990 and 2017, and compared the age-standardized incidence and mortality rates among different World Health Organization (WHO) regions. Results Globally, AEMT incidence rates varied across WHO regions and countries. The estimated agestandardized average incidence rates of AEMT were 309 [95% uncertainty interval (UI), 270 to 351], 340 (298 to 384), 401 (348 to 458), and 439 (376 to 505) per 100,000 population across the world in 1990, 2000, 2010, and 2017, respectively, showing an increasing trend in the new occurrence of adverse events. The incidence rate among women (469/100,000) was higher compared to men (409/100,000) in 2017. Between 1990 and 2017, we observed an upward trend in the incidence rates of AEMT across global regions, with a substantial increase in the incidence by 42% (27 to 57) between the years 1990 and 2017, translated to an annualized rate of incline of 1.5%. In the age group of 60-64 years, the incidence rates increased by 96% in 2017

show abstract

Section: Discussionmentioning

confidence: 95%

Global Incidence and Mortality Trends due to Adverse Effects of Medical Treatment, 1990–2017: A Systematic Analysis from the Global Burden of Diseases, Injuries and Risk Factors Study

Nauman¹,

Soteriades²,

Hashim³

et al. 2020

Cureus

View full text Add to dashboard Cite

show abstract

“…We used information derived from our systematic review to develop a preliminary dataset that we presented to clinicians in iterative workshops in order to understand which data fields should be integrated into the minimum required dataset, their priority for integration, as well as their reporting sequence [ 15 ]. In parallel, we completed qualitative fieldwork to inform our understanding of the clinical nature of ADEs, clinicians’ workflow in diagnosing ADEs, and challenges related to their documentation [ 19 - 21 ]. This informed our design decisions and will be integral to the successful implementation of the set of data fields [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

Adverse Drug Event Reporting From Clinical Care: Mixed-Methods Analysis for a Minimum Required Dataset

et al. 2018

Self Cite

View full text Add to dashboard Cite

BackgroundPatients commonly transition between health care settings, requiring care providers to transfer medication utilization information. Yet, information sharing about adverse drug events (ADEs) remains nonstandardized.ObjectiveThe objective of our study was to describe a minimum required dataset for clinicians to document and communicate ADEs to support clinical decision making and improve patient safety.MethodsWe used mixed-methods analysis to design a minimum required dataset for ADE documentation and communication. First, we completed a systematic review of the existing ADE reporting systems. After synthesizing reporting concepts and data fields, we conducted fieldwork to inform the design of a preliminary reporting form. We presented this information to clinician end-user groups to establish a recommended dataset. Finally, we pilot-tested and refined the dataset in a paper-based format.ResultsWe evaluated a total of 1782 unique data fields identified in our systematic review that describe the reporter, patient, ADE, and suspect and concomitant drugs. Of these, clinicians requested that 26 data fields be integrated into the dataset. Avoiding the need to report information already available electronically, reliance on prospective rather than retrospective causality assessments, and omitting fields deemed irrelevant to clinical care were key considerations.ConclusionsBy attending to the information needs of clinicians, we developed a standardized dataset for adverse drug event reporting. This dataset can be used to support communication between care providers and integrated into electronic systems to improve patient safety. If anonymized, these standardized data may be used for enhanced pharmacovigilance and research activities.

show abstract

“…However, despite PASS having been adopted by some hospitals, the positive effects are often negligible, and the system override rate continues to remain quite high. Previous studies have documented that monitoring systems do have positive impacts on medical performance [6] and also have highlighted a high level of override rates (73.3%) in PASS contexts [5,7]. One study also presented an insignificant correlation between the system in hospitals and prescription behavior [8].…”

Section: Introduction Backgroundmentioning

confidence: 97%

Exploring the Impact of the Prescription Automatic Screening System in Health Care Services: Quasi-Experiment (Preprint)

Li¹,

Guo²,

Hsu³

et al. 2018

Preprint

View full text Add to dashboard Cite

Background: Hospitals have deployed various types of merging technologies (e.g., intelligent diagnosis systems, mobile tablets). However, the impacts of these technologies on behavior change are rather vague, especially the computer-aided diagnosis systems. Although the critical roles of information systems have been demonstrated in previous research, there still remains a substantial amount of unsatisfying results after the implementation of information systems in hospitals, such as the high rate of overrides relating to alerting information generated from Prescription Automatic Screening System (PASS). Objective: The objective of this study is to systematically explore the imperative role of PASS, an aided diagnosis system, on physicians' behavior change in order to clarify the various factors relative to the effective use of PASS. Methods: In order to systematically examine the various impacts of PASS, we adopted a quasiexperiment by using a two-year observation dataset from two hospitals. We then analyzed the data related to physicians' prescription behavior both before and after the deployment of PASS and eliminated the influences from a variety of perplexing factors by utilizing a control hospital which does not use a PASS system. In total, 754 physicians were included in this experiment composed of 11,054 patients, 400 physicians in the treatment group and 354 physicians in the control group, respectively. Moreover, this study was preceded by a series of interviews, which was employed to identify the moderators and we adopted propensity score matching (PSM) integrated with the difference-in-differences (DID) so as to isolate the impacts of PASS. Results: The impacts of PASS on prescription errors and medical treatment costs were all significant (Error: 95% CI -0.40-0.11; P=0.001; Costs: 95% CI -0.75--0.12; P=0.007), and help explain physician behavior over performance. Moreover, institutional pressure decreased the impact of PASS on the error of prescription (95% CI 0.07-0.55; P=0.012) and workload, respectively, thus reducing the impact of PASS on medical treatment costs (95% CI 0.18-0.39; P<0.001). We also suspect that other pressures (e.g., title and risk of illness) also impair physicians' attention to the intelligent alerting from PASS. However, the impacts of PASS did not change among physicians having a higher title or experience or when treating diseases demonstrating high risk. The researcher posits that this is because these physicians will focus more attention on their patients in these situations, regardless of having access to an intelligent system. Conclusions: Auxiliary diagnosis systems (such as PASS) do play a critical role in physicians' behavior change. However, workload and organizational pressure remain problematic in this context, since they will impair the positive impacts of auxiliary diagnosis systems on performance. This again highlights the importance of considering both technical and organizational issues to obtain the highest level of effectiveness when deploying IT in...

show abstract

Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study

Cited by 61 publications

References 30 publications

Global Incidence and Mortality Trends due to Adverse Effects of Medical Treatment, 1990–2017: A Systematic Analysis from the Global Burden of Diseases, Injuries and Risk Factors Study

Global Incidence and Mortality Trends due to Adverse Effects of Medical Treatment, 1990–2017: A Systematic Analysis from the Global Burden of Diseases, Injuries and Risk Factors Study

Adverse Drug Event Reporting From Clinical Care: Mixed-Methods Analysis for a Minimum Required Dataset

Exploring the Impact of the Prescription Automatic Screening System in Health Care Services: Quasi-Experiment (Preprint)

Contact Info

Product

Resources

About