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Half of all Hospital Adverse Drug Reactions are Preventable, Study Says | DeLand Medical Malpractice Attorney

Half of all Hospital Adverse Drug Reactions are Preventable, Study Says

More than half of all adverse drug reactions that occur among patients in hospitals and emergency rooms are preventable, according to a new study.

Researchers from the Nordic School of Public Health in Gothenburg, Sweden, say the findings that preventable adverse drug reactions or PADRs are so widespread has large implications for healthcare systems.

According to the study, the frequency of PADRs leading to hospitalization or emergency visit among adult out-patients was 2 percent and that 51 percent of all such adverse d drug reactions or ADRs were preventable. Among the elderly, preventability was as high as 71 percent. For in-patients, the frequency of PADRs was 1.6 percent and 45 percent of all such ADRs were preventable.

“The reasons for high numbers of PADRs are varied; they may include poor co-ordination of care, lack of time and knowledge among health professionals, and lack of patient education,” said pharmacist Katja Hakkarainen, from the Nordic School of Public Health.

Preventable ADRs can take many forms. One is internal bleeding associated with the use of anticoagulant (blood-thinning) therapy to prevent clotting; if this is poorly monitored, severe problems can occur.

Inappropriate use of painkillers can also lead to severe gastrointestinal bleeding. Other types of PADR may occur when there is a contraindication for a particular treatment which is ignored or overlooked. It may also be that, although the treatment is correct, the patient takes too high a dose.

Hakkarainen and colleagues undertook the first meta-analysis of preventable adverse drug reactions (PADRs) in both out-patients and in-patients. In a meta-analysis, evidence from a number of studies is combined in order to give a result with more statistical power. By bringing together the results of 22 studies, the researchers were able to measure both the frequency of ADRs and their preventability in a hospital and emergency setting.

“We knew that ADRs were common and that some of them were preventable,” said Hakkarainen, “but no previous study had looked at their frequency in both in-patients and out-patients. We would have liked also to investigate their frequency in primary care, where the ADR did not lead to a hospital or emergency visit, but there are very few data available on this issue.”

At a time when more and more medications are available and used across all age groups, the frequency of both ADRs and PADRs is bound to increase, the researchers say, emphasizing that it is important to differentiate between the two.

For example, some ADRs occur even though the treatment was correct and in line with recommendations, and some of these may be relatively minor when compared with the benefit of the therapy. These ADRs are considered to be non-preventable.

Other studies have found that PADRs are more severe than non-preventable ones, the researchers say.

In one study, 32 percent of all PADRs were severe – potentially life threatening, causing permanent damage, or requiring intensive care – while only 19 percent of the non-preventable ADRs were severe. In another, 65 percent of all PADRs caused a hospital admission or prolonged a hospital stay, while most non-preventable ADRs were less severe, with only 33 percent leading to hospital admission or a prolonged stay.

“Unfortunately there is no consensus today on what to do to prevent ADRs”, Hakkarainen said. “But our finding that they are so common means that it is imperative to create a climate in which they are not hidden and that there is no ‘blame and shame’ involved. Human error will occur while humans continue to work in healthcare and use medicines. Thus, safety measures need to be incorporated into the health system.”

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

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