Preventability analysis of adverse drug reactions in a Jordanian hospital: a prospective observational study

Background Adverse drug reactions remain to be an issue that compromise patient's safety in Jordan and worldwide. In Jordan, an assessment of factors involved in preventability of adverse drug reactions has not been conducted previously. Objectives To describe the proportion of preventable adverse drug reactions, and the causes of hospital-related preventable adverse reactions in one Jordanian hospital. Methods A prospective observational study of 4 months duration conducted by clinical pharmacists in the hospital. Setting Surgical and medical wards in one Jordanian private hospital. Main outcome measure Proportions of admissions related to adverse drug reactions, proportions of preventable reactions and analysis of the factors involved in the preventable adverse drug reactions. Results Out of 350 admissions recorded during the study period, a total of 38 (10.8%) adverse reactions were detected. Among those, 29 (8.3%) were detected in the hospital and 9 (2.6%) were the cause of the hospital admission. Many (44.7%) of the adverse drug reactions were preventable (31.6% were probably preventable and 13.1% were definitely preventable). About half (55.3%) were unpreventable. Insufficient monitoring was involved in 29.4% of the preventable adverse reactions and inappropriate dosing and drug-drug interactions were independently responsible for 17.6% of the preventable adverse reactions. Conclusion A high proportion of the identified adverse drug reactions were found to be preventable. Insufficient monitoring and inappropriate dosing were the most important factors associated with preventable adverse drug reactions. Nationally, more focused efforts need to be stimulated to prevent preventable adverse drug reactions in hospitals.