Analysing electronic prescribing data to detect potential undocumented adverse reactions to medications

Identifying instances where medications have been discontinued due to an adverse/allergic reaction however the patients' allergy status has not been updated appropriately. Data were evaluated in an established electronic prescribing and medicines administration system within a medium-sized teaching hospital.

Details of all medications stopped due to allergic reaction over a 3-year period were extracted from the electronic prescribing system. The instances where the discontinued medication was not included in the patients' allergy status were investigated further. Patient records were explored to determine whether genuine reactions had occurred.

434 medications were discontinued due to drug allergy over the time period. Of these, 26 cases were identified where a documented drug reaction had not been added to the patients' inpatient allergy history.

Electronic systems provide a wealth of information which can be analysed to identify gaps in processes and systems. This information can be leveraged to improve these systems and subsequently improve patient safety.