1. Hospital admissions caused by adverse drug events: an Australian prospective study.
- Author
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Phillips, Alexandra L., Nigro, Olimpia, Macolino, Karen A., Scarborough, Kirsty C., Doecke, Christopher J., Angley, Manya T., and Shakib, Sepehr
- Subjects
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HOSPITAL admission & discharge , *PATIENTS , *CONFIDENCE intervals , *DRUG side effects , *EPIDEMIOLOGY , *HOSPITAL emergency services , *LONGITUDINAL method , *MEDICAL records , *STATISTICAL sampling , *STATISTICAL hypothesis testing , *DATA analysis , *RETROSPECTIVE studies , *DATA analysis software , *DESCRIPTIVE statistics , *TERTIARY care - Abstract
Objective To assess the frequency of adverse drug event (ADE)-related admissions (ADE-RAs) during a prospective medical record review of patients admitted to a metropolitan tertiary referral hospital. Methods Potential ADE-RA cases were identified by examination of case records of randomly selected patients. Cases were assessed by an expert panel to measure study outcomes, which were the frequency (ADEs and ADE-RAs) as well as type, likelihood of causality, severity, avoidability and detection of ADEs. Results Of the 370 subjects, 59 (16.0%) had a confirmed ADE-RA, with 15 (4.1%) of these serious and preventable. The 59 ADE-RAs were a result of 72 discreet ADEs. Adverse drug reactions were the most common type of ADE, followed by non-compliance. Of the 72 discreet ADEs, 31.9% were classified as 'probable' or 'highly probable'. Most ADEs (54.2%) were classified as 'definitely avoidable', 34.7% were classified as 'severe' and 21.8% were classified as both 'definitely avoidable' and 'severe'. Half the ADEs were detected after the patient had been admitted and most were detected by medical practitioners. Antineoplastics followed by antidiabetic agents were most frequently implicated. Conclusions Implementing a systems approach that involves multiple strategies, such as improving tertiary-to-primary care information transfer and promoting medication adherence through education programs, is necessary to tackle the problem of avoidable ADE-RAs and the associated cost burden. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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