International prevalence of adverse drug events in hospitals: an analysis of routine data from England, Germany, and the USA

Stausberg, Jürgen

doi:10.1186/1472-6963-14-125

Cited by 80 publications

(73 citation statements)

References 25 publications

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“…Therefore, lately and using a more comprehensive approach, the studies of the ADE tend to include both poisoning by drugs (AP) and adverse reaction of drugs (ADR) [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

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

2017

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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.

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“…Therefore, lately and using a more comprehensive approach, the studies of the ADE tend to include both poisoning by drugs (AP) and adverse reaction of drugs (ADR) [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

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

2017

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“…Variable drug responses (VDRs) are a widespread clinical occurrence; for instance, adverse drug events occur in 1 in 20 hospital patients in the United States (Stausberg, 2014). Large interindividual variability in the expression and function of hepatic xenobiotic metabolizing enzymes and transport proteins contributes to dose-limiting toxicities of certain therapeutics (Yang et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Mechanistic Basis of Altered Morphine Disposition in Nonalcoholic Steatohepatitis

Dzierlenga

Clarke

Hargraves

et al. 2014

J Pharmacol Exp Ther

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Morphine is metabolized in humans to morphine-3-glucuronide (M3G) and the pharmacologically active morphine-6-glucuronide (M6G). The hepatobiliary disposition of both metabolites relies upon multidrug resistance-associated proteins Mrp3 and Mrp2, located on the sinusoidal and canalicular membrane, respectively. Nonalcoholic steatohepatitis (NASH), the severe stage of nonalcoholic fatty liver disease, alters xenobiotic metabolizing enzyme and transporter function. The purpose of this study was to determine whether NASH contributes to the large interindividual variability and postoperative adverse events associated with morphine therapy. Male Sprague-Dawley rats were fed a control diet or a methionine-and choline-deficient diet to induce NASH. Radiolabeled morphine (2.5 mg/kg, 30 mCi/kg) was administered intravenously, and plasma and bile (0-150 or 0-240 minutes), liver and kidney, and cumulative urine were analyzed for morphine and M3G. The antinociceptive response to M6G (5 mg/kg) was assessed (0-12 hours) after direct intraperitoneal administration since rats do not produce M6G. NASH caused a net decrease in morphine concentrations in the bile and plasma and a net increase in the M3G/morphine plasma area under the concentration-time curve ratio, consistent with upregulation of UDP-glucuronosyltransferase Ugt2b1. Despite increased systemic exposure to M3G, NASH resulted in decreased biliary excretion and hepatic accumulation of M3G. This shift toward systemic retention is consistent with the mislocalization of canalicular Mrp2 and increased expression of sinusoidal Mrp3 in NASH and may correlate to increased antinociception by M6G. Increased metabolism and altered transporter regulation in NASH provide a mechanistic basis for interindividual variability in morphine disposition that may lead to opioid-related toxicity.

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“…Reports and research on the occurrences of adverse events shows that a great number of patients experience adverse events while receiving health care all over the world [4] [5] [6] [7]. An international study conducted in England, Germany and the USA, with focus on medication errors, found that the prevalence of adverse event related to drugs alone ranged from 3.22% to 5.64% of the patients hospitalized in 2006 [8]. There have been a greater media and research attention to patient safety and the effect of staffing on the occurrence of adverse events [9] [10] [11].…”

Section: Incidence Of Adverse Eventsmentioning

confidence: 99%

The Relationship between Understaffing of Nurses and Patient Safety in Hospitals—A Literature Review with Thematic Analysis

Glette¹,

Aase²,

Wiig³

2017

OJN

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Introduction: Patient safety and the occurrence of adverse events in hospitals is a topic which has been widely addressed over the last decades. In that respect, there has been an increasing interest in the effect of working conditions on patient safety, and whether understaffing and adverse events are correlated. This paper therefore reports results from a study of understaffing of nurses understood as a lack of nurses available to conduct the tasks required of them. This implies that nurses are forced to ignore or postpone important tasks, thereby compromising patient safety. Purpose: The purpose of the study is to increase the knowledge of understaffing of hospital nurses, and the consequences that understaffing may have on patient safety. Methods: A literature search of the databases Chinal, Medline, Cochrane library, Isi Web of Science and Academic Search premiere was conducted in the period January 2014 to February, 2016. Results: Results are categorized into two main themes and four subthemes. The first main theme describes the direct relationship between understaffing and patient safety. Poor staffing increases the risk of mortality, and adverse conditions such as pressure ulcers, deep vein thrombosis and hospital-related infections. The second main theme relates to the indirect implications of understaffing for patient safety. These implications pertain to the lack of time that nurses could give each patient, limitations in the quality of nursing, and challenges in safe medication administration. Conclusions: The study documents the relationship between understaffing of nurses and adverse events in hospitals, revealingthat understaffing of nurses is a risk factor for hospitalized patients.

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International prevalence of adverse drug events in hospitals: an analysis of routine data from England, Germany, and the USA

Cited by 80 publications

References 25 publications

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

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

Mechanistic Basis of Altered Morphine Disposition in Nonalcoholic Steatohepatitis

The Relationship between Understaffing of Nurses and Patient Safety in Hospitals—A Literature Review with Thematic Analysis

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