Sandra Kane-Gill1, Rhonda S Rea, Margaret M Verrico, Robert J Weber. 1. Department of Pharmacy and Therapeutics, Center for Pharmacoinformatics and Outcomes Research, School of Pharmacy, University of Pittsburgh, PA 15261, USA. kansl@upmc.edu
Abstract
PURPOSE: The rates of adverse drug events (ADEs) associated with high-cost and high-use drugs in the intensive care unit (ICU) were studied. METHODS: This retrospective analysis was conducted from October 1997 through June 2001 in a 647-bed academic medical center with over 120 ICU beds. Adult patients with a documented ADE occurring in the ICU were included in the analysis. ADE information, including suspected medication, causality, preventability, and severity, was extracted from the institutional ADE database. Published definitions of ADEs and published scales for causality and severity assessments were used. High-cost medications were those in the top 50% of cumulative ICU medication costs, and high-use medications accounted for the upper 50% of all medications used in the ICU. Between-group comparisons of ADE rates, preventability, and severity associated with high-cost and high-use medications were conducted. RESULTS: Of the 17 medications that were considered high cost, 9 (53%) were associated with ADEs. Of the 15 medications that met the criteria for high-use drugs, 12 (80%) were associated with ADEs. The rates of ADEs associated with high-cost and high-use drugs did not significantly differ (43% versus 75%, respectively; p = 0.098). ADEs associated with high-cost and high-use medications were categorized as mild (15% versus 10%, respectively), moderate (52% versus 50%, respectively), and severe (33% versus 40%, respectively) (p > 0.05). CONCLUSION: The frequency, severity, and preventability of ADEs in the ICU were not associated with a drug's cost or frequency of use. Monitoring priorities of the critical care pharmacist should not be dictated by cost alone but should include frequency of use and the potential for causing an ADE.
PURPOSE: The rates of adverse drug events (ADEs) associated with high-cost and high-use drugs in the intensive care unit (ICU) were studied. METHODS: This retrospective analysis was conducted from October 1997 through June 2001 in a 647-bed academic medical center with over 120 ICU beds. Adult patients with a documented ADE occurring in the ICU were included in the analysis. ADE information, including suspected medication, causality, preventability, and severity, was extracted from the institutional ADE database. Published definitions of ADEs and published scales for causality and severity assessments were used. High-cost medications were those in the top 50% of cumulative ICU medication costs, and high-use medications accounted for the upper 50% of all medications used in the ICU. Between-group comparisons of ADE rates, preventability, and severity associated with high-cost and high-use medications were conducted. RESULTS: Of the 17 medications that were considered high cost, 9 (53%) were associated with ADEs. Of the 15 medications that met the criteria for high-use drugs, 12 (80%) were associated with ADEs. The rates of ADEs associated with high-cost and high-use drugs did not significantly differ (43% versus 75%, respectively; p = 0.098). ADEs associated with high-cost and high-use medications were categorized as mild (15% versus 10%, respectively), moderate (52% versus 50%, respectively), and severe (33% versus 40%, respectively) (p > 0.05). CONCLUSION: The frequency, severity, and preventability of ADEs in the ICU were not associated with a drug's cost or frequency of use. Monitoring priorities of the critical care pharmacist should not be dictated by cost alone but should include frequency of use and the potential for causing an ADE.
Authors: Pascale Carayon; Tosha B Wetterneck; Randi Cartmill; Mary Ann Blosky; Roger Brown; Robert Kim; Sandeep Kukreja; Mark Johnson; Bonnie Paris; Kenneth E Wood; James Walker Journal: BMJ Qual Saf Date: 2013-09-19 Impact factor: 7.035
Authors: Sandra L Kane-Gill; Florentina E Sileanu; Raghavan Murugan; Gregory S Trietley; Steven M Handler; John A Kellum Journal: Am J Kidney Dis Date: 2014-12-06 Impact factor: 8.860
Authors: Joanna E Klopotowska; Rob Kuiper; Hendrikus J van Kan; Anne-Cornelie de Pont; Marcel G Dijkgraaf; Loraine Lie-A-Huen; Margreeth B Vroom; Susanne M Smorenburg Journal: Crit Care Date: 2010-10-04 Impact factor: 9.097