Identification of Adverse Drug Reactions Using the ICD‐10 Australian Modification Clinical Coding Surveillance

Abstract

Background: Adverse drug reactions (ADRs) pose a significant burden on patients and the health system. ADR reporting contributes to data that guide patient safety strategies. Despite numerous strategies aimed to improve ADR reporting rates, ADRs continue to be under-reported. Aim: To compare the effectiveness and efficiency of identifying institutional ADRs using the International Classification of Diseases 10th Revision Australian Modification (ICD-10-AM) clinical coding surveillance and spontaneous reporting. Method: Medical records of multi-day (staying overnight or longer) inpatient separations (single patient encounter resulting in discharge) assigned an ADR-related ICD-10-AM code were retrospectively reviewed to verify if an ADR had occurred and whether the codes assigned were appropriate. ADR reports received via the spontaneous reporting system were also reviewed. ADRs were assessed for causality, seriousness and type of reaction. The drugs, type of adverse reactions involved and the resource implications of this reporting method were also investigated. Results: ICD-10-AM coding surveillance and spontaneous reporting resulted in an ADR reporting rate of 3.3% and 0.4% of inpatient separations, respectively. ICD-10-AM coding surveillance was more likely to identify type A ADRs than spontaneous reports although there were no significant differences in seriousness or causality. The ICD-10-AM codes assigned were appropriate in 94% of cases, with the omission of drugs being the most common discrepancy. Conclusion:The ICD-10-AM coding surveillance is an effective and efficient method of improving ADR reporting by utilising data collected for administrative purposes.

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“…Moreover, ADRs are one of the causing factors for hospital admissions [4][5][6]. It had been found that the incidence of ADRs induced hospital admissions is 6.7% of all medical admissions [7].…”

Diagnosis-based and external cause-based criteria to identify adverse drug reactions in hospital ICD-coded data: application to an Australia population-based study

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“…This is significantly higher than 19 min per event described by Hodgkinson et al . in 2009 . This study did however include multiple researchers reviewing each chart for quality assurance purposes, and many of the patients required manual review of multiple chart volumes.…”