Preventable Adverse Drug Events Among Inpatients: A Systematic Review

Area of Science:

• Pediatric patient safety
• Medication error analysis
• Healthcare quality improvement

Background:

• Patient harm from medication errors is a significant concern in healthcare.
• Systematic reviews on medication errors and resulting harm in pediatric populations are limited.
• Understanding the incidence and severity of preventable adverse drug events (pADEs) in children is crucial for targeted prevention strategies.

Purpose of the Study:

• To systematically review the incidence and severity of preventable adverse drug events (pADEs) in pediatric inpatient settings.
• To identify factors influencing pADE rates and severity in children.
• To inform evidence-based practices for reducing medication-related harm in pediatric care.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (CINAHL, Medline, Scopus, Cochrane Library, Embase).
• Studies published between January 2000 and December 2017, in English, focusing on pediatric inpatients and measuring pADEs via chart review or direct observation were selected.
• Data extraction included definitions of medication errors and harm, pADE incidence and severity rates, and study quality assessment.

Main Results:

• Twenty-two studies were included in the review.
• The incidence of pADEs varied: 0-17 per 1000 patient days (or 1.3% of medication errors) in general pediatric wards and 0-29 per 1000 patient days (or 1.5% of medication errors) in ICUs.
• Hospital-wide incidence reached up to 74 pADEs per 1000 patient days (or 2.6% of medication errors), with the majority of pADEs being of minor severity.

Conclusions:

• Medication errors in pediatric settings infrequently lead to patient harm, and when harm occurs, it is typically minor.
• Limited literature exists on the severity of pADEs, necessitating further research.
• The implementation of health information technology was associated with a decreased incidence of harm.