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Drug-related problems and adverse drug events: negligence, litigation and prevention
1Novartis India Limited, Khetan Bhavan, Mumbai.
Abstract:
Since the inclusion of medical profession under Consumer Protection Act, Indian doctors are facing malpractice suits. The incidence of adverse events (AEs) is 3.4-3.7, of adverse drug events (ADEs) is 2.4-6.5 and of adverse drug reactions (ADRs) is 6.7 per 100 hospital admissions. The complications of drug-related problems (DRPs) include therapeutic failure (TF) in 23% and new medical problems (NMPs) in 10% and could lead to serious permanent disability and death in majority (42%). The incidence of negligence in serious ADEs and death is 34% and 51%, respectively. Proportion of preventable ADEs is 28-50%. Errors occur most often in prescribing (39-56%) and result in malpractice claims in 13-25% of cases. Rational prescribing, improved therapeutic knowledge through re-training and effective use of computers in prescribing could prevent errors and reduce economic consequences for patients, doctors and hospitals.
Insights
Indian doctors face malpractice suits due to adverse events. Improving prescribing practices and retraining can prevent errors, reducing harm and economic impact for all involved.
Area of Science:
- Medical Law and Ethics
- Pharmacovigilance
- Patient Safety
Background:
- The Indian medical profession faces increased malpractice suits following inclusion under the Consumer Protection Act.
- Adverse events (AEs), adverse drug events (ADEs), and adverse drug reactions (ADRs) occur frequently in hospital admissions.
Purpose of the Study:
- To analyze the incidence and impact of drug-related problems (DRPs) and medical errors in Indian healthcare.
- To identify the proportion of preventable adverse drug events and the role of prescribing errors in malpractice claims.
Main Methods:
- The study reviews existing data on the incidence of AEs, ADEs, ADRs, and DRPs in hospital settings.
- Analysis includes the rates of therapeutic failure, new medical problems, and negligence associated with serious ADEs and deaths.
Main Results:
- Adverse drug events (ADEs) occur in 2.4-6.5% of hospital admissions, with drug-related problems (DRPs) leading to therapeutic failure (23%) and new medical problems (10%).
- A significant proportion of preventable ADEs range from 28-50%, and prescribing errors (39-56%) contribute to 13-25% of malpractice claims.
- Negligence is implicated in 34% of serious ADEs and 51% of deaths.
Conclusions:
- Drug-related problems and medical errors pose substantial risks, leading to severe patient outcomes and significant economic consequences.
- Rational prescribing, continuous medical education, and technological integration in prescribing are crucial for error reduction and improved patient safety.