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Adverse drug event rates in six community hospitals and the potential impact of computerized physician order entry for prevention
Journal
Journal of general internal medicine
Volume
25
Number
1
Pages / Article-Number
31-8
Keywords
drug safety, adverse drug events, potential adverse drug event, computerized physician order entry, community hospital, Massachusetts
Mesh terms
Adolescent; Adult; Adverse Drug Reaction Reporting Systems, trends; Aged; Aged, 80 and over; Cohort Studies; Drug-Related Side Effects and Adverse Reactions, prevention & control; Female; Hospitals, Community, trends; Humans; Male; Medical Order Entry Systems, trends; Medication Errors, trends; Medication Systems, Hospital, trends; Middle Aged; Retrospective Studies; Young Adult
Abstract
Medications represent a major cause of harm and are costly for hospitalized patients, but more is known about these issues in large academic hospitals than in smaller hospitals.; To assess the incidence of adverse drug events (ADEs) in six community hospitals.; Multicenter, retrospective cohort study.; Six Massachusetts community hospitals with 100 to 300 beds.; From 109,641 adult patients hospitalized from January 2005 through August 2006, a random sample of 1,200 patients was drawn, 200 per site.; ADEs and preventable ADEs.; Presence of an ADE was evaluated using an adaptation of a trigger instrument developed by the Institute for Health Care Improvement. Independent reviewers classified events by preventability, severity, and potential for preventability by computerized physician order entry (CPOE).; A total of 180 ADEs occurred in 141 patients (rate, 15.0/100 admissions). Overall, 75% were preventable. ADEs were rated as serious in 49.4% and life threatening in 11.7%. Patients with ADEs were older (mean age, 74.6 years, p > 0.001), more often female (60.3%, p = 0.61), and more often Caucasian (96.5%, p > 0.001) than patients without ADEs. Of the preventable ADEs, 81.5% were judged potentially preventable by CPOE.; The incidence of ADEs in these community hospital admissions was high, and most ADEs were preventable, mostly through CPOE. These data suggest that CPOE may be beneficial in this setting.
