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Adverse drug events caused by medication errors in medical inpatients

Beat Hardmeier1, Suzanne Braunschweig, Marzia Cavallaro

  • 1Division of Clinical Pharmacology and Toxicology, Department of Medicine, University Hospital, Zürich, Switzerland.

Swiss Medical Weekly
|December 22, 2004
PubMed
Abstract

Insights

Medication errors causing adverse drug events (ADEs) are a concern. Error-associated ADEs (eADEs) were rare in medical inpatients but significantly contributed to hospital admissions.

Area of Science:

  • Medical Inpatient Care
  • Pharmacovigilance
  • Patient Safety

Background:

  • Growing concern over medication errors leading to adverse drug events (ADEs).
  • Focus on the frequency and characteristics of error-associated ADEs in medical inpatients.

Purpose of the Study:

  • To investigate the incidence and nature of error-associated ADEs in a cohort of medical inpatients.
  • To differentiate between error-associated ADEs (eADEs) and adverse drug reactions (ADRs).

Main Methods:

  • Analysis of medical inpatients with ADEs or ADE-related hospital admissions using "event monitoring".
  • Independent physician evaluation to classify ADEs as incident ADEs or pre-existing.
  • Categorization of ADEs into eADEs (e.g., wrong dosage) and ADRs (e.g., appropriate use).

Main Results:

  • 7.5% of 6383 patients experienced incident ADEs; 0.4% were incident eADEs.
  • Common error types included missed contraindications and overdoses.
  • eADEs accounted for 1.2% of ADE-related hospital admissions, compared to 2.9% for ADRs.

Conclusions:

  • Incident eADEs occurred in 1 in 250 patients, representing about 6% of all incident ADEs.
  • eADEs constituted a significant proportion (30%) of ADE-related hospital admissions.
  • While infrequent, eADEs have a substantial impact on hospital admissions in medical inpatients.

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