Vermijdbare en niet-vermijdbare medicatiegerelateerde schade in het ziekenhuis*

Objective

To analyse the prevalence of preventable medication-related injuries and non-preventable adverse drug reactions (ADRs) as well as their determinants.

Design

Prospective study using medical records.

Method

Over a 5-month period, 603 patients were included from 2 hospitals that each had a functional digital prescription system and a clinical decision support system. The patients had been hospitalised for more than 24 hours on the geriatrics, general internal medicine, gastroenterology, or rheumatology wards. The medication-related injuries the patients had experienced were evaluated.

Results

A total of 349 patients (58%) had experienced 1 or more instances of medication-related injuries, of whom 307 (88%) had had non-preventable adverse drug reactions. The most common medication-related injuries and ADRs were constipation, diarrhoea, dyspnoea, increased INR, nausea, dizziness and falls. The determinants identified for both preventable injuries and non-preventable ADRs were largely similar.

Conclusion

In this study, more than half of the patients admitted to the hospitals were harmed by drugs, of which most were non-serious, non-preventable ADRs. These results indicate that one must be alert to the frequent occurrence of adverse drug reactions in hospitals. By intervening early – also in cases of less serious adverse reactions – the well-being of hospitalised patients might be improved.

Conflict of interest: interests have been declared (disclosure forms provided by the authors are available along with the full text of this article at www.ntvg.nl; search for A5051, click on ‘Belangenverstrengeling’ (Conflict of interest). Financial support: This work was made possible in part by an unconditional grant from ZonMW (The Netherlands Organisation for Health Research and Development, grant no. 94504109).