Identifying and preventing adverse drug events in elderly hospitalised patients: a randomised trial of a program to reduce adverse drug effects.
J Nutr Health Aging
; 14(1): 57-61, 2010 Jan.
Article
em En
| MEDLINE
| ID: mdl-20082055
ABSTRACT
OBJECTIVES:
Evaluate the impact of educational intervention in decreasing ADEs in elderly patients in a hospital setting.DESIGN:
Randomised prospective study.SETTING:
The study was performed in France in the Paris area, in 16 rehabilitation geriatric centres of APHP (Assistance Publique - Hôpitaux de Paris). Patient capacity per centre varied from 15 to 57 with a total of 526.PARTICIPANTS:
All the patients > or = 65 years hospitalized during the 4 week study period were included. MEASUREMENTS During a first 2 week phase without intervention ADE's were recorded in all centres. Then units were then randomised for an educational intervention or not. The educational phase lasted 1 week, without ADE tracking. Then, both types of units (I+ and I-) recorded ADEs for 2 weeks. Possible drug-related incidents were detected using a standardized check list (nurses) and a weekly review of all charts by investigators. Possible drug-related incidents were analysed by a group of reviewers selected from the authors to classify them as ADE or not.RESULTS:
576 patients (mean age 83.6 +/- 7.9 years) were consecutively included. The mean number of drugs at inclusion was 9.4 +/- 4.24 drugs per patient. 223 out of 755 events were considered "probable" ADEs (29.5%). Among the 223 ADEs, 62 (28%) could have been prevented. The main outcome of this trial was the change in the proportion of ADEs in elderly patients in the intervention-units, compared to the control group. The main errors were to high a dose (26%), double therapy (21%), under dose (13%), inappropriate drug (13%), drug-drug interaction (6%), previous same adverse drug reaction (3%) and miscellaneous (11.18%). After a specific educational intervention program, there were fewer ADEs in the intervention group (n = 38, 22%) than in the control group (n = 63, 36%; p = 0.004).CONCLUSION:
Educational programs could help reduce the prevalence of ADEs by 14% and encourage physicians to change outdated prescription habits.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Educação de Pacientes como Assunto
/
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
/
Pacientes Internados
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Aged80
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Female
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article