Adverse drug events—Analysis of a decade. A Portuguese case-study, from 2004 to 2013 using hospital database

Abstract

PurposeThe goal of this study was to characterise adverse drug events (ADE), including both adverse drug reaction (ADR) and accidental poisoning by drugs (AP), considering age, gender, length of stay (LOS), number of deaths and year, during the period 2004–2013. Additionally distributions of the ten’s most frequent ADR and AP were characterized, considering age-group and gender.MethodsA retrospective descriptive nationwide study was conducted, based on the hospital discharges database in Portugal from 2004 to 2013, using ICD-9. Events were identified based on the following codes: from E930 to E949.9 and from E850 to E858.9.ResultsA total of 9 320 076 patients were discharged within this period, with 133 688 patients (1.46%) having at least one ADE, 4% of them related with AP. The mean age of these patients was 63.79 years (SD 21.31), 54.50% were female and the mean LOS was 14.05 days (SD 22.19). Patient with AP had a mean age of 41.06 years (SD 34.05), 54.70% were female and LOS was 7.15 days (SD 19.42). We have identified 10.691 deaths that represent 8.00% from the total of patients with an ADE. The patients above 65 years were more affected by ADR and children below 18 were more affected by AP.ConclusionIn the last decade an increasing trend of ADR were observed and an AP pattern relatively stable. Elderly people and children were the age groups most affected. Antibiotics (in ADR) and benzodiazepine-based tranquilizers (in AP) were the major problems. This is a huge, increasing and challenging problem. Further research, using individual and contextual risk factors should be developed to understand spatiotemporal variability, promoting tailored interventions, within and across countries.

In-hospital adverse drug events: analysis of trend in Portuguese public hospitals

“…Regarding the class of drugs associated with in-hospital ADEs, we observed that the antineoplastic/immunosuppressant drugs were among the most frequent causes of events, similar to other studies carried out at a national and international levels 4,5,10,18 . Antibiotics, adrenal cortical steroids, anticoagulants, and diuretics not elsewhere specified were also included among the five most frequent causes of ADEs.…”

“…The most recent Portuguese studies, based on administrative data, showed an ADE frequency of between 1.46% and 1.88% 10,11,21 , but they also did not differentiate between the ADE present at the time of admission and the in-hospital one.…”

“…A study carried out in nine acute care public hospital centers, using the clinical record review methodology, identified an incidence of 12.5% adverse events in the year 2013, of which 9.8% were associated with drug errors, representing the third most frequent adverse event 9 . According to other studies carried out in Portuguese public hospitals, using administrative data, 1.46% and 1.88% of hospitalized patients showed at least one ADE 10,11 .…”

“…The criteria for the selection of the ADE codes were based on the literature analyzed 10,16,17,18 . The in-hospital ADEs were identified on the BDMH using the E850-858.9 codes (50 codes) for AP and E930-949.9 codes (171 codes) for ADRs which were not present at the moment of admission.…”

Patient safety culture in Norwegian home health nursing: a cross-sectional study of healthcare provider’s perceptions of the teamwork and safety climates

“…In Norway, older people (aged 67 years or above) account for almost 60% of the 149,551 patients receiving HHN each year [14]. This patient group is especially vulnerable to adverse events because they often have complex care needs caused by multimorbidity, polypharmacy, and multiple functional limitations [6,[15][16][17][18]. In addition, the risks to older patients in their own homes are rather different from those in institutions, e.g., different environment, roles, and failure to monitor over long periods.…”