Prevalence, nature and potential preventability of adverse drug events – a population‐based medical record study of 4970 adults
Open Access
- 20 June 2014
- journal article
- Published by Wiley in British Journal of Clinical Pharmacology
- Vol. 78 (1), 170-183
- https://doi.org/10.1111/bcp.12314
Abstract
To estimate the 3 month prevalence of adverse drug events (ADEs), categories of ADEs and preventable ADEs, and the preventability of ADEs among adults in Sweden. Further, to identify drug classes and organ systems associated with ADEs and estimate their seriousness. A random sample of 5025 adults in a Swedish county council in 2008 was drawn from the Total Population Register. All their medical records in 29 inpatient care departments in three hospitals, 110 specialized outpatient clinics and 51 primary care units were reviewed retrospectively in a stepwise manner, and complemented with register data on dispensed drugs. ADEs, including adverse drug reactions (ADRs), sub-therapeutic effects of drug therapy (STEs), drug dependence and abuse, drug intoxications from overdose, and morbidities due to drug-related untreated indication, were detected during a 3 month study period, and assessed for preventability. Among 4970 included individuals, the prevalence of ADEs was 12.0% (95% confidence interval (CI) 11.1, 12.9%), and preventable ADEs 5.6% (95% CI 5.0, 6.2%). ADRs (6.9%; 95% CI 6.2, 7.6%) and STEs (6.4%; 95% CI 5.8, 7.1%) were more prevalent than the other ADEs. Of the ADEs, 38.8% (95% CI 35.8–41.9%) was preventable, varying by ADE category and seriousness. ADEs were frequently associated with nervous system and cardiovascular drugs, but the associated drugs and affected organs varied by ADE category. The considerable burden of ADEs and preventable ADEs from commonly used drugs across care settings warrants large-scale efforts to redesign safer, higher quality healthcare systems. The heterogeneous nature of the ADE categories should be considered in research and clinical practice for preventing, detecting and mitigating ADEs.Funding Information
- National Corporation of Swedish Pharmacies (Apoteket AB)
- Region V�stra G�taland, Sweden
This publication has 69 references indexed in Scilit:
- Cost of illness of patient-reported adverse drug events: a population-based cross-sectional surveyBMJ Open, 2013
- Modelling drug-related morbidity in Sweden using an expert panel of pharmacists’International Journal of Clinical Pharmacy, 2012
- The patient perspective in research on major depressionBMC Psychiatry, 2011
- Concerns and beliefs about medicines and inappropriate medications: An internet-based survey on risk factors for self-reported adverse drug events among older adultsThe American Journal of Geriatric Pharmacotherapy, 2010
- Fatal drug poisonings in a Swedish general populationBMC Clinical Pharmacology, 2009
- Adverse Drug Reactions in Hospital In-Patients: A Prospective Analysis of 3695 Patient-EpisodesPLOS ONE, 2009
- The new Swedish Prescribed Drug Register—Opportunities for pharmacoepidemiological research and experience from the first six monthsPharmacoepidemiology and Drug Safety, 2006
- Which drugs cause preventable admissions to hospital? A systematic reviewBritish Journal of Clinical Pharmacology, 2006
- Inter- and intra-rater reliability for classification of medication related events in paediatric inpatientsQuality and Safety in Health Care, 2006
- Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patientsBMJ, 2004