Influence of adverse drug events on morbidity and mortality in intensive care units: the JADE study

Ohta, Yoshinori; Sakuma, Mio; Koike, Kazuhiko; Bates, David W.; Morimoto, Takeshi

doi:10.1093/intqhc/mzu081

Cited by 36 publications

(34 citation statements)

References 17 publications

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“…The rate of ADEs associated with overrides may appear low relative to other published data including total ADE rates. [16][17][18] However, this was related to the study design, which limited ADE review to the override alerts for which the related medication was administered to the patient. Based on our appropriateness evaluation, inappropriate overrides accounted for approximately 10% of overrides in the ICU.…”

Section: Discussionmentioning

confidence: 99%

“…These patients may be at greater risk than general ward patients for a variety of reasons, including altered pharmacokinetics, an increased length of stay and an increased number of medications administered. [12][13][14][15][16] Continuation of a patient"s home medications may also be a potential cause of ADEs, given a patients altered pharmacokinetics. Prospective cohort studies identifying ADEs in the ICU found them to be common, with rates varying from 30.6 to 96.5 per 1,000 patient days, associated with morbidity but not associated with increased mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Prospective cohort studies identifying ADEs in the ICU found them to be common, with rates varying from 30.6 to 96.5 per 1,000 patient days, associated with morbidity but not associated with increased mortality. [17,18] Given the benefits of CDS, overrides of available alerts may lead to increased risk of patient harm in the ICU.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of medication-related clinical decision support alert overrides in the intensive care unit

Wong

Amato

Seger

et al. 2017

Journal of Critical Care

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of medication-related clinical decision support alert overrides in the intensive care unit

Wong

Amato

Seger

et al. 2017

Journal of Critical Care

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“…4 DRPs, when unresolved, can aggravate patients' clinical conditions, prolonging hospitalization and even leading to death. 8,9 In the Neonatal Intensive Care Unit (NICU), there are diseases such as infections, heart disease and respiratory problems, which require complex medical interventions, 10 highlighting the lack of studies on DRP in this population, especially in patients with heart diseases. A study conducted in an Egyptian hospital of children with heart disease, estimated that the prevalence of DRP in this group was 100%.…”

Section: Introductionmentioning

confidence: 99%

Drug-Related Problems in Cardiac Neonates Under Intensive Care

Nascimento

Leopoldino

Santos

et al. 2020

Rev. paul. pediatr.

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Objective: To determine the frequency and nature of the Drug Related Problems (DRP) in neonates with cardiac diseases admitted to an Intensive Care Unit. Methods: This prospective cross-sectional study was developed at the Neonatal Intensive Care Unit (NICU) of a teaching maternity hospital in Brazil from January 2014 to December 2016. All neonates diagnosed with any heart disease (congenital heart disease, cardiomyopathy, arrhythmias, etc.) and who were admitted to the NICU for more than 24 hours with at least one prescribed drug were included in the study. Demographic and clinical data were collected from the records of the institution’s clinical pharmacy service. DRP and their respective interventions were independently reviewed and classified by two pharmacists. DRP classification was performed through the Pharmaceutical Care Network Europe v6.2 system. Results: 122 neonates were included in the study. The frequency of neonates exposed to DRP was 76.4% (confidence interval of 95% [95%CI] 65.9–82.0), with a mean of 3.2±3.8 cases/patient. In total, 390 DRP were identified, of which 49.0% were related to “treatment effectiveness”, 46.7% to “adverse reactions” and 1.0% to “treatment costs”. The medicines most involved in DRP were Vancomycin (10.2%; n=46), Meropenem (8.0%; n=36) and Furosemide (7.1%; n=32). Pharmacists performed 331 interventions, of which 92.1% were accepted by physicians and nurses. Conclusions: The study showed that DRP are very frequent in patients with cardiac diseases hospitalized in the NICU, predominating problems related to the effectiveness and safety of the drug treatment.

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“…We recently conducted the Japan Adverse Drug Events (JADE) study, which evaluated the incidence of ADRs and medication errors among Japanese hospitalized inpatients. [9][10][11][12][13][14] In the present study, we evaluated the usefulness of the NA to categorize ADRs among suspected ADRs using the JADE database and tried to modify it into a convenient tool to use in daily clinical practice.…”

mentioning

confidence: 99%

Improving the assessment of adverse drug reactions using the Naranjo Algorithm in daily practice: The Japan Adverse Drug Events Study

Murayama

Sakuma

Morimoto

2018

Pharmacology Res & Perspec

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It is difficult to determine adverse drug reactions (ADRs) in daily complicated clinical practice in which many kinds of drugs are prescribed. We evaluated how well the Naranjo Algorithm (NA) categorized ADRs among suspected ADRs. The Japan Adverse Drug Events (JADE) study was a prospective cohort study of 3459 inpatients. After all suspected ADRs were reported from research assistants, a single physician reviewer independently assigned an NA score to each. After all NA score of suspected ADRs were scored, two physician reviewers discussed and determined ADRs based on the literature. We investigated the sensitivity and specificity of NA and each component to categorize ADRs among suspected ADRs. A total of 1579 suspected ADRs were reported in 962 patients. Physician reviewers determined 997 ADRs. The percentage of ADRs was 94% if the total NA score reached 5. The modified NA consisted of 5 components that showed high classification abilities; its area under the curve (AUC) was 0.92 for categorizing ADRs, the same as the original. When we set the total NA score cut‐off value to 5, specificity was 0.95 and sensitivity was 0.59. When we reclassified NA components as binary variables, the specificity increased to 0.98 with a cut‐off value of 4 and yielded an AUC of 0.93. In conclusion, we showed that both NA and modified NA could categorize ADRs among suspected ADRs with a high likelihood in daily clinical practice.

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Influence of adverse drug events on morbidity and mortality in intensive care units: the JADE study

Abstract: ADEs were common in ICUs and significantly associated with longer length of ICU stay but did not influence on mortality.

Cited by 36 publications

References 17 publications

Evaluation of medication-related clinical decision support alert overrides in the intensive care unit

Evaluation of medication-related clinical decision support alert overrides in the intensive care unit

Drug-Related Problems in Cardiac Neonates Under Intensive Care

Improving the assessment of adverse drug reactions using the Naranjo Algorithm in daily practice: The Japan Adverse Drug Events Study

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