Quality assurance through adverse drug reaction reporting: improving hypnotic prescribing

While adverse drug reactions (ADRs) contribute to excessive health care costs through increased patient morbidity and mortality, most hospital ADR reporting programs are ineffective in documenting the adverse reactions to drugs that occur in their institutions. Furthermore, the ADR reporting programs have an untapped potential as a quality assurance (QA) tool; ADR reports provide a means of identifying potential problems in patient care. If 10-20% of hospitalized patients develop adverse effects while taking medications and over 50% of the iatrogenic events are avoidable, educational strategies and prospective monitoring could reduce this significant cause of patient morbidity. At Memorial Hospital (Ormond Beach, FL), routine QA screening detected a potential problem with the use of Halcion (triazolam). A plan of action, which included a drug use evaluation (DUE), educational efforts, and hypnotic prescribing guidelines was developed to address and resolve the concerns raised by initial ADR reports.