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Brown NJ, Doran E, Greenslade JH, et al. Retrospective study of the prevalence and characteristics of adverse drug events in adults who present to an Australian emergency department. Emerg Med Australas. 2022;doi: 10.1111/1742-6723.13929.
Brown, N. J., Doran, E., Greenslade, J. H., Lukin, B., Cottrell, N., Jaramillo, F., Coombes, I., Donovan, P., & Cullen, L. (2022). Retrospective study of the prevalence and characteristics of adverse drug events in adults who present to an Australian emergency department. Emergency medicine Australasia : EMA, . https://doi.org/10.1111/1742-6723.13929
Brown, Nathan J, et al. "Retrospective study of the prevalence and characteristics of adverse drug events in adults who present to an Australian emergency department." Emergency medicine Australasia : EMA vol. (2022). doi: https://doi.org/10.1111/1742-6723.13929
Brown NJ, Doran E, Greenslade JH, Lukin B, Cottrell N, Jaramillo F, Coombes I, Donovan P, Cullen L. Retrospective study of the prevalence and characteristics of adverse drug events in adults who present to an Australian emergency department. Emerg Med Australas. 2022 Jan 01; doi: 10.1111/1742-6723.13929. Epub 2022 Jan 01. PMID: 34973155.
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Emerg Med Australas. 2022 Jan 01; doi: 10.1111/1742-6723.13929. Epub 2022 Jan 01.

Retrospective study of the prevalence and characteristics of adverse drug events in adults who present to an Australian emergency department.

Emergency medicine Australasia : EMA

Nathan J Brown, Elizabeth Doran, Jaimi H Greenslade, Bill Lukin, Neil Cottrell, Fabian Jaramillo, Ian Coombes, Peter Donovan, Louise Cullen

Affiliations

  1. Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
  2. Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
  3. School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia.
  4. Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
  5. Brisbane North PHN/Metro North Hospital and Health Service, Brisbane, Queensland, Australia.
  6. Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
  7. Department of Clinical Pharmacology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

PMID: 34973155 DOI: 10.1111/1742-6723.13929

Abstract

OBJECTIVE: To determine the burden, on the ED, of harm from unintentional adverse drug events (ADEs) in the community.

METHODS: A retrospective, observational study of 936 randomly selected presentations to a level 6 ED at a principal referral hospital in Brisbane, Australia, in November 2017. Clinical records were screened by a pharmacist, who identified suspected ADEs. All suspected ADEs and a random selection of presentations without ADEs were reviewed by an expert panel, which classified, by consensus: occurrence and type of ADE, contribution of ADE to presentation, severity of harm and preventability of presentation. Medication-related ED presentations (ADE-Ps) and potential ADEs were, respectively, defined as presentations directly attributable to an ADE, and medication events that occurred but did not cause the ED presentation. Descriptive data analysis was performed.

RESULTS: The median (interquartile range) age of patients was 40 (27-58) years, with 49.7% (95% confidence interval [CI] 46.5-52.9) being male. The prevalences of ADE-Ps and potential ADEs were 9.2% (95% CI 7.5-11.3) and 5.0% (95% CI 3.8-6.6), respectively. The severity of harm was classified as 'death or likely permanent harm' in 4.7% (95% CI 0.2-9.1) of ADE-Ps, 'temporary harm' (89.5%, 95% CI 83.1-96.0) and 'minimal or no harm' (5.8%, 95% CI 0.9-10.8). Most (79.1%, 95% CI 70.5-87.7) ADE-Ps were preventable.

CONCLUSIONS: There is a high burden on emergency care because of unintended medication harm in the community. Interventions to reduce such harm are likely to require a co-ordinated primary, acute and public healthcare response. The high proportion of presentations with potential ADEs indicates opportunity for harm mitigation in the ED.

© 2022 Australasian College for Emergency Medicine.

Keywords: adult; drug-related side effects and adverse reaction; emergency service, hospital; prevalence; retrospective study

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