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International Journal of Clinical Pharmacy

, Volume 34, Issue 6, pp 902–910 | Cite as

Implementing a clinical pharmacy survey of adverse drug events in a French emergency department

  • Lucien RouletEmail author
  • Nathalie Asseray
  • Martin Dary
  • Anne Chiffoleau
  • Gilles Potel
  • Françoise Ballereau
Research Article

Abstract

Background The prevalence of adverse drug events (ADEs) occurring in the ambulatory setting is high, requiring the development of a coherent and comprehensive patient-safety policy framework. Former experiences demonstrated that emergency department (ED) surveillance can help characterise the burden of outpatient ADEs. We developed a clinical pharmacy programme called the clinical pharmacy survey of adverse drug events (CPSA) to support interventions and research projects in the area of ADE prevention and management. Objective To design a survey to identify and describe ADEs in patients visiting the medical ED of our tertiary care hospital. We report the results of the first 2 years of CPSA implementation and an assessment of its performance. Setting The medical ED of a French 3,000-bed tertiary care hospital. Method Between January 2008 and December 2009, adult patients visiting our medical ED were included during randomised time slots. Data were collected by pharmacy students. ADEs were documented by a trained physician pharmacist team using the chart review method. Main outcome measure The primary outcome was the number of patients visiting our ED with an ADE. The CPSA attributes were assessed on the basis of the Centers for Disease Control and Prevention’s 2001 updated guidelines for evaluating public health surveillance systems. Results Of the 1,035 included patients, 201 experienced an ADE at the ED visit (19.4 %; 95 % confidence interval 15.8–23.0 %). Forty-seven ADEs (23.4 %) were unrelated to the patient’s chief complaint. An ADE was the leading cause of 154 in the 1,035 admissions (14.9 %). The assessment of our method on the basis of the Centers for Disease Control and Prevention guidelines showed good performances in terms of data quality, stability, flexibility, timeliness, and acceptability, but not in terms of simplicity and representativeness. The profile of patients with an ADE at admission and detected ADEs did not significantly differ between years 2008 and 2009. Conclusion Our experience demonstrates that clinical pharmacists can successfully implement a survey process of ADEs in an ED over time. Our method seems basic enough to suit most health care facilities with pharmacy students.

Keywords

Adverse drug event CPSA Emergency department France Pharmacoepidemiology Survey 

Notes

Acknowledgments

The authors thank Guillaume Brément, Sébastien Ruaud, Claire Denis, Laura Bloino, Claire Delville, Marion Cruveilhier, Romain Goument, Pierre-Yves Joubi, Emilie Peron, Thibaut Grare, Emilie Simon, Florence Renaudineau, Julie Lambert, Xavier Guy, Charlotte Bronsard, Alice Bozec, Emilie Bouju, Cyrille Puel and Mélanie Bonal for carrying out data collection.

Funding

None.

Conflicts of interests

The authors have no conflict of interest to declare.

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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Lucien Roulet
    • 1
    • 2
    Email author
  • Nathalie Asseray
    • 1
    • 2
  • Martin Dary
    • 1
  • Anne Chiffoleau
    • 3
  • Gilles Potel
    • 1
    • 2
  • Françoise Ballereau
    • 2
    • 4
  1. 1.Emergency DepartmentTeaching HospitalNantesFrance
  2. 2.Faculty of Medical SciencesUPRES EA 3826NantesFrance
  3. 3.Department of Clinical PharmacologyTeaching HospitalNantesFrance
  4. 4.MedqualTeaching HospitalNantesFrance

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