Abstract
Adverse drug events continue to be the single most frequent source of healthcare mishaps, continually placing patients at risk of injury. This is not unexpected, given that drug treatment is the most common medical intervention and medication use is a highly complex, multidisciplinary, and largely manual process. Assessing the actual safety of drug use has been historically difficult, mainly because traditional methods such as chart audits and voluntary reporting of data have been shown to be expensive, insensitive, and largely ineffective for detecting mistakes in drug administration and drug related adverse clinical events (ADEs). Computerized methods for detecting ADEs, employing sentinel words or "triggers" in a patient's medical record, are effective but expensive and require customized software linkage to pharmacy databases. This paper describes the use of the "trigger tool", a relatively low cost and "low tech" modification of the automated technique. The adapted technique appears to increase the rate of ADE detection approximately 50-fold over traditional reporting methodologies.
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Selected References
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- Bates D. W., Boyle D. L., Vander Vliet M. B., Schneider J., Leape L. Relationship between medication errors and adverse drug events. J Gen Intern Med. 1995 Apr;10(4):199–205. doi: 10.1007/BF02600255. [DOI] [PubMed] [Google Scholar]
- Bates D. W., Cullen D. J., Laird N., Petersen L. A., Small S. D., Servi D., Laffel G., Sweitzer B. J., Shea B. F., Hallisey R. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA. 1995 Jul 5;274(1):29–34. [PubMed] [Google Scholar]
- Classen D. C., Pestotnik S. L., Evans R. S., Burke J. P. Computerized surveillance of adverse drug events in hospital patients. JAMA. 1991 Nov 27;266(20):2847–2851. [PubMed] [Google Scholar]
- Classen D. C., Pestotnik S. L., Evans R. S., Burke J. P. Description of a computerized adverse drug event monitor using a hospital information system. Hosp Pharm. 1992 Sep;27(9):774, 776-9, 783. [PubMed] [Google Scholar]
- Classen D. C., Pestotnik S. L., Evans R. S., Lloyd J. F., Burke J. P. Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1997 Jan 22;277(4):301–306. [PubMed] [Google Scholar]
- Ebbesen J., Buajordet I., Erikssen J., Brørs O., Hilberg T., Svaar H., Sandvik L. Drug-related deaths in a department of internal medicine. Arch Intern Med. 2001 Oct 22;161(19):2317–2323. doi: 10.1001/archinte.161.19.2317. [DOI] [PubMed] [Google Scholar]
- Evans R. S., Classen D. C., Stevens L. E., Pestotnik S. L., Gardner R. M., Lloyd J. F., Burke J. P. Using a hospital information system to assess the effects of adverse drug events. Proc Annu Symp Comput Appl Med Care. 1993:161–165. [PMC free article] [PubMed] [Google Scholar]
- Jha A. K., Kuperman G. J., Teich J. M., Leape L., Shea B., Rittenberg E., Burdick E., Seger D. L., Vander Vliet M., Bates D. W. Identifying adverse drug events: development of a computer-based monitor and comparison with chart review and stimulated voluntary report. J Am Med Inform Assoc. 1998 May-Jun;5(3):305–314. doi: 10.1136/jamia.1998.0050305. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jick H., Miettinen O. S., Shapiro S., Lewis G. P., Siskind V., Slone D. Comprehensive drug surveillance. JAMA. 1970 Aug 31;213(9):1455–1460. [PubMed] [Google Scholar]
- Lesar T. S., Briceland L., Stein D. S. Factors related to errors in medication prescribing. JAMA. 1997 Jan 22;277(4):312–317. [PubMed] [Google Scholar]