Risk Factors for Adverse Drug Events Among Nursing Home Residents

Abstract

HIGH RATES of adverse events occur in the context of providing medical care in the United States, as documented by the Institute of Medicine's report To Err is Human: Building a Safer Health System.¹ Many of these events are adverse drug events (ADEs), defined to include preventable and nonpreventable events related to the use of medications. A series of studies^2,3 has examined ADEs in hospital settings. However, much less information is available about these events in nonacute settings. We recently examined the incidence and preventability of ADEs among the residents of 18 nursing homes during 1 year and found high rates of ADEs (1.89 ADEs per 100 resident-months, of which 0.96 were preventable).⁴ This is not surprising, given the magnitude and intensity of drug use in nursing homes. Nursing home residents are frail, elderly, often have difficulty expressing and ascribing symptoms, and frequently suffer from multiple physical problems—a constellation of factors that may place them at special risk for developing problems related to their extensive drug regimens.