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30-Day Potentially Avoidable Readmissions Due to Adverse Drug Events
- Source :
- Journal of Patient Safety. 17:e379-e386
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Objective To analyze the patterns of potentially avoidable readmissions due to adverse drug events (ADEs) to identify the most appropriate risk reduction interventions. Methods In this observational study, we analyzed a random sample of 534 potentially avoidable 30-day readmissions from 10,275 consecutive discharges from the medical department of an academic hospital. Readmissions due to ADEs were reviewed to identify the causative drugs and the severity and interventions to prevent them. Results Seventy cases (13.1%) of readmission were partially or predominantly due to ADEs, of which, 58 (82.9%) were serious ADEs. Overall, 65 (92.9%) of the ADEs have been confirmed to be preventable. Inappropriate prescribing was identified as the cause of ADE in 34 cases (48.6%) mainly involving diuretics, analgesics, or antithrombotics: misprescribing n = 19 (27.1%), underprescribing n = 8 (11.4%), and overprescribing n = 7 (10.0%). The remaining half of preventable ADEs (n = 36; 51.4%) were related to suboptimal patient monitoring/education, such as adherence issues (n = 6; 8.6%) or lack of monitoring (n = 31; 44.3%). In 64 cases (91.4%), the readmission could have been potentially prevented by better monitoring for drug efficacy/disease control, or for predictable side effect. Thirty-three (97.1%) of the 34 ADEs due to inappropriate prescribing could have also been prevented by better monitoring. Conclusions Adverse drug events accounted for approximately 13% of 30-day preventable readmissions. A half were due to prescription errors involving mainly diuretics, analgesics, or antithrombotics, and the other half were due to suboptimal patient monitoring/education, most frequently with antineoplastics. Both these avoidable causes may represent opportunities to reduce the total drug-related adverse events.
- Subjects :
- Drug
Pediatrics
medicine.medical_specialty
Drug-Related Side Effects and Adverse Reactions
Side effect
Leadership and Management
business.industry
media_common.quotation_subject
Public Health, Environmental and Occupational Health
Psychological intervention
030204 cardiovascular system & hematology
Patient Readmission
Disease control
Efficacy
03 medical and health sciences
0302 clinical medicine
Emergency medicine
Humans
Medicine
Observational study
030212 general & internal medicine
Medical prescription
business
Adverse effect
media_common
Subjects
Details
- ISSN :
- 15498425 and 15498417
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Journal of Patient Safety
- Accession number :
- edsair.doi.dedup.....8ceeb2852f1c27e9df0a45e6eb3df117