[Prevalence and factors associated with preventable adverse drug events leading to hospital admission]. / Prevalencia y factores asociados a los acontecimientos adversos prevenibles por medicamentos que causan el ingreso hospitalario.

OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.

Prevalencia y factores asociados a los acontecimientos adversos prevenibles por medicamentos que causan el ingreso hospitalario / No disponible

Objetivo: Determinar la prevalencia de acontecimientosadversos por medicamentos (AAM) que causan el ingreso hospitalario,y evaluar los AAM prevenibles, identificando los medicamentosimplicados, los tipos de errores y los factores asociados asu aparición.Método: Estudio observacional de 6 meses, realizado en 6unidades médicas de un hospital universitario, sobre los AAM quemotivaron o contribuyeron al ingreso hospitalario.Resultados: Se detectaron un total de 259 AAM, de los que159 (61,4%) fueron potencialmente prevenibles. La prevalenciade ingresos causados directamente por AAM fue del 6,7% (177) ypor AAM prevenibles del 4,7% (125). Además, se detectaron 82AAM que contribuyeron al ingreso. Los factores de riesgo deAAM prevenibles fueron: edad 65-74 años (OR = 1,40) o ≥ 75años (OR = 2,70), automedicación (OR = 15,55), prescripción enatención primaria (OR = 2,88) y uso de medicamentos de margenterapéutico estrecho (OR = 2,40). Los medicamentos más frecuentementeimplicados en los AAM prevenibles fueron: AINE yaspirina (32,5%), diuréticos (15,3%), antihipertensivos (9,1%) ydigoxina (7,7%). Los principales tipos de errores identificados fueron:falta de seguimiento (20,7%), prescripción de medicamentoinapropiado (15,7%) o de dosis elevadas (12,0%), falta de tratamientopreventivo (15,7%), falta de adherencia (10,6%) y automedicacióninapropiada (10,1%).Conclusiones: Una elevada proporción (4,7%) de ingresoshospitalarios está motivada por AAM potencialmente prevenibles.Los resultados obtenidos apoyan la necesidad de adoptar medidasenfocadas a mejorar el seguimiento y la prescripción de los tratamientos,y a promover la educación sanitaria sobre medicamentos,dirigidas prioritariamente a los pacientes de edad avanzada ya los medicamentos de margen terapéutico estrecho

Objective: To determine the prevalence of adverse drugevents (ADEs) leading to hospital admission, and to assess thosethat were potentially preventable, identifying the drug classesinvolved, types of medication errors and the factors associatedwith the preventable ADEs.Method: An observational study, over a six-month period onADEs that lead or contributed to hospital admissions, carried outin 6 medical units of a university hospital.Results: A total of 259 ADEs were detected of which 159(61.4%) were assessed to be potentially preventable. The overallprevalence of admissions directly due to ADEs was of 6.7% (177)and to preventable ADEs of 4.7% (125). In addition, 82 ADEsthat contributed to hospital admission were detected. Risk factorsfor preventable ADEs were patient age of 65-74 (OR = 1.40) or≥ 75 years (OR = 2.70), self-medication (OR = 15.55), prescriptionin primary care (OR = 2,88) and the use of narrow therapeuticindex drugs (OR = 2.40). The drug classes most frequentlyinvolved 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 inappropriatedrug (15.7%) or of an excessive dosage (12.0%), lack ofpreventive treatment (15.7%), non-adherence (10.6%) and inappropriateself-medication (10.1%) were the most commonly identifiedtypes of error. Conclusions: A high proportion (4.7%) of hospital admissionsare caused by potentially preventable ADEs. Resultsobtained justified the need to adopt measures directed at improvingsurveillance and prescription quality, and educating patients insafe drug use, focusing especially on older patients and narrowtherapeutic index drugs