August 11, 2016

Preventable adverse drug reactions

Query 16-03: Preventable adverse drug reactions (ADR) as percentage of total ADRs

This project was funded in June 2016 for two years. The query will be addressed in two phases. In phase I, we are conducting a retrospective chart review of patients who were diagnosed with an ADE to determine the preventability of the event, identify contributing factors, determine the ADE-related harm and interventions required, and identify the kind of drug re-exposure that would likely cause a future repeat ADE. In phase II, we will link phase I data to BC health data (PharmaNet) to determine the proportion of ADE patients that were re-exposed to contraindicated medications.

At this point in time, we have completed phase I data collection. Data of 1234 patients were studied and 1356 ADEs were found. ADEs due to adverse drug reactions (35%) and non-adherence (19%) were most common, most moderate (65%) or severe (31%) and two-thirds required either major or minor interventions in hospital.  We deemed 64% (95%CI:62-67%) of ADEs to be preventable and 29% (95%CI:26-31%) were repeat events. The most commonly implicated drug classes were coumarin derivatives (9%), and opiate agonists (9%), and common contributing factors included inadequate patient counselling (16%), lack of follow-up after a change in regimen (12%), and insufficient laboratory monitoring (11%). On multivariable patient-level analyses, mental health diagnoses, diabetes, and a prior ADE to the same drug were associated with patients having preventable ADEs. Diabetes and renal failure were significant in association with patients having repeat ADEs.

We have recently received the data for Phase II of the study from Population Data BC and we expect to deliver findings within 6 months from today’s date (May 18, 2020).

Hohl et al. Repeat exposures to culprit drugs contribute to adverse drug events in emergency department patients. 2017 (CAEP abstract).

Hohl et al. Preventable adverse drug events in Canadian emergency departments. 2017 (CAEP abstract).

Woo et al. Factors contributing to the development of adverse drug events treated in emergency departments. 2017 (CAEP abstract).

Wickham et al. Preventable and repeat adverse drug events in Canadian emergency department patients. 2017 (CAHSPR abstract).

Woo et al. Preventable adverse drug events in Canadian emergency departments. 2019 (CAEP abstract).

Woo SA, Cragg A, Wickham ME, Peddie D, Balka E, Scheuermeyer F, Villanyi D, Hohl CM. Methods for evaluating adverse drug event preventability in emergency department patients. BMC Red Res Methodol. 2018;18:160.

Hohl et al. Repeat adverse drug events to outpatient medications. CMAJ Open (Accepted)

Woo et al. Preventable adverse drug events: Descriptive epidemiology. BJCP, published Oct 20/19

For more information contact: Jessica (Lifang) Wang. Research Coordinator. [email protected]   514.934.1934 ext.44718