BACKGROUND: Hospital admissions due to adverse drug events (ADEs) are expensive, and many may be preventable, yet few institutions have ongoing surveillance for these events. OBJECTIVE: To evaluate the use of a computer-based ADE monitor to identify admissions due to ADEs and to measure the associated costs. DESIGN: Prospective cohort study in one tertiary care hospital. PARTICIPANTS: All patients admitted to nine medical and surgical units in a tertiary care hospital over an 8-month period. MAIN OUTCOME MEASURE: Admissions to the hospital due to an adverse drug event. METHODS: A computer-based monitoring program generated alerts suggesting that an ADE might be present. A trained reviewer then evaluated the record. RESULTS: Among the 3238 admissions, 76 (2.3%, 1.4% after adjusting for sampling) were found to be caused by an ADE. Of these ADEs, 78% were severe and 28% were preventable. Estimated costs were $16,177 per ADE, and $10,375 per preventable ADE; annualized costs to the hospital were $6.3 million per year for all ADEs, and $1.2 million for preventable ADEs. CONCLUSIONS: Many admissions were caused by ADEs, although our point estimate undoubtedly represents a lower bound. These events were mostly severe, often preventable, and expensive. The computer-based monitoring system represents a practical approach for identifying ADEs that occur in outpatients and cause admission to the hospital.
BACKGROUND: Hospital admissions due to adverse drug events (ADEs) are expensive, and many may be preventable, yet few institutions have ongoing surveillance for these events. OBJECTIVE: To evaluate the use of a computer-based ADE monitor to identify admissions due to ADEs and to measure the associated costs. DESIGN: Prospective cohort study in one tertiary care hospital. PARTICIPANTS: All patients admitted to nine medical and surgical units in a tertiary care hospital over an 8-month period. MAIN OUTCOME MEASURE: Admissions to the hospital due to an adverse drug event. METHODS: A computer-based monitoring program generated alerts suggesting that an ADE might be present. A trained reviewer then evaluated the record. RESULTS: Among the 3238 admissions, 76 (2.3%, 1.4% after adjusting for sampling) were found to be caused by an ADE. Of these ADEs, 78% were severe and 28% were preventable. Estimated costs were $16,177 per ADE, and $10,375 per preventable ADE; annualized costs to the hospital were $6.3 million per year for all ADEs, and $1.2 million for preventable ADEs. CONCLUSIONS: Many admissions were caused by ADEs, although our point estimate undoubtedly represents a lower bound. These events were mostly severe, often preventable, and expensive. The computer-based monitoring system represents a practical approach for identifying ADEs that occur in outpatients and cause admission to the hospital.
Authors: R L Howard; A J Avery; S Slavenburg; S Royal; G Pipe; P Lucassen; M Pirmohamed Journal: Br J Clin Pharmacol Date: 2006-06-26 Impact factor: 4.335
Authors: Steven M Handler; Richard L Altman; Subashan Perera; Joseph T Hanlon; Stephanie A Studenski; James E Bost; Melissa I Saul; Douglas B Fridsma Journal: J Am Med Inform Assoc Date: 2007-04-25 Impact factor: 4.497
Authors: Robyn Tamblyn; Allen Huang; Robert Perreault; André Jacques; Denis Roy; James Hanley; Peter McLeod; Réjean Laprise Journal: CMAJ Date: 2003-09-16 Impact factor: 8.262
Authors: Emily Beth Devine; Ryan N Hansen; Jennifer L Wilson-Norton; N M Lawless; Albert W Fisk; David K Blough; Diane P Martin; Sean D Sullivan Journal: J Am Med Inform Assoc Date: 2010 Jan-Feb Impact factor: 4.497
Authors: Terry S Field; Jerry H Gurwitz; Leslie R Harrold; Jeffrey M Rothschild; Kristin Debellis; Andrew C Seger; Leslie S Fish; Lawrence Garber; Michael Kelleher; David W Bates Journal: J Am Med Inform Assoc Date: 2004-08-06 Impact factor: 4.497