Otero López M J, Alonso Hernández P, Maderuelo Fernández J A, Ceruelo Bermejo J, Domínguez-Gil Hurlé A, Sánchez Rodríguez A
Servicios de Farmacia (ISMP-España), Hospital Universitario de Salamanca, Paseo de San Vicente 58, 37007 Salamanca, Spain.
Farm Hosp. 2006 May-Jun;30(3):161-70. doi: 10.1016/s1130-6343(06)73967-8.
To determine the prevalence of adverse drug events (ADEs) leading to hospital admission, and to assess those that were potentially preventable, identifying the drug classes involved, types of medication errors and the factors associated with the preventable ADEs.
An observational study, over a six-month period on ADEs that lead or contributed to hospital admissions, carried out in 6 medical units of a university hospital.
A total of 259 ADEs were detected of which 159 (61.4%) were assessed to be potentially preventable. The overall prevalence of admissions directly due to ADEs was of 6.7% (177) and to preventable ADEs of 4.7% (125). In addition, 82 ADEs that contributed to hospital admission were detected. Risk factors for preventable ADEs were patient age of 65-74 (OR = 1.40) or = 75 years (OR = 2.70), self-medication (OR = 15.55), prescription in primary care (OR = 2,88) and the use of narrow therapeutic index drugs (OR = 2.40). The drug classes most frequently involved in preventable ADEs were NSAID and aspirin (32.5%), diuretics (15.3%), antihypertensives (9.1%) and digoxin (7.7%). Inadequate therapy monitoring (20.7%), prescription of an inappropriate drug (15.7%) or of an excessive dosage (12.0%), lack of preventive treatment (15.7%), non-adherence (10.6%) and inappropriate self-medication (10.1%) were the most commonly identified types of error.
A high proportion (4.7%) of hospital admissions are caused by potentially preventable ADEs. Results obtained justified the need to adopt measures directed at improving surveillance and prescription quality, and educating patients in safe drug use, focusing especially on older patients and narrow therapeutic index drugs.
确定导致住院的药物不良事件（ADEs）的发生率，并评估那些潜在可预防的事件，识别所涉及的药物类别、用药错误类型以及与可预防ADEs相关的因素。
在一所大学医院的6个医疗科室进行了一项为期6个月的观察性研究，研究导致或促成住院的ADEs。
共检测到259起ADEs，其中159起（61.4%）被评估为潜在可预防。直接由ADEs导致的住院总体发生率为6.7%（177例），可预防ADEs导致的住院发生率为4.7%（125例）。此外，还检测到82起促成住院的ADEs。可预防ADEs的危险因素包括患者年龄65 - 74岁（OR = 1.40）或≥75岁（OR = 2.70）、自我用药（OR = 15.55）、初级保健中的处方（OR = 2.88）以及使用窄治疗指数药物（OR = 2.40）。可预防ADEs中最常涉及的药物类别是非甾体抗炎药和阿司匹林（32.5%）、利尿剂（15.3%）、抗高血压药（9.1%）和地高辛（7.7%）。治疗监测不足（20.7%）、开具不适当药物（15.7%）或过量药物（12.）、缺乏预防性治疗（15.7%）、不依从（10.6%）和不适当的自我用药（10.1%）是最常见的错误类型。
高比例（4.7%）的住院是由潜在可预防的ADEs引起的。所得结果证明有必要采取措施，旨在改善监测和处方质量，并对患者进行安全用药教育，尤其关注老年患者和窄治疗指数药物。
