Implementing a clinical pharmacy survey of adverse drug events in a French emergency department
- 426 Downloads
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.
KeywordsAdverse drug event CPSA Emergency department France Pharmacoepidemiology Survey
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.
Conflicts of interests
The authors have no conflict of interest to declare.
- 9.Queneau P, Bannwarth B, Carpentier F, Guliana JM, Bouget J, Trombert B, Association Pédagogique Nationale pour l’Enseignement de la Thérapeutique (APNET), et al. Emergency department visits caused by adverse drug events: results of a French survey. Drug Saf. 2007;30(1):81–8.PubMedCrossRefGoogle Scholar
- 13.Kohn LT, Corrigan JM, Donaldson MS, editors. Committee on Quality of Health Care in America, Institute of Medicine. To err is human: building a safer health system. Washington, DC: National Academy Press; 2000. ISBN: 9780309068376.Google Scholar
- 21.Council of Europe, Committee of Ministers. Resolution ResAP (2001)2 concerning the pharmacist’s role in the framework of health security. 2001. https://wcd.coe.int/ViewDoc.jsp?id=193721&Site=CM&BackColorInternet=C3C3C3&BackColorIntranet=EDB021&BackColorLogged=F5D383, 30 June 2012.
- 22.Council of Europe, Committee of Ministers. Recommendation Rec(2006)7 on management of patient safety and prevention of adverse events in health care. 2006. https://wcd.coe.int/ViewDoc.jsp?id=1005439&Site=CM&BackColorInternet=C3C3C3&BackColorIntranet=EDB021&BackColorLogged=F5D383, 30 June 2012.
- 28.German RR, Lee LM, Horan JM, Milstein RL, Pertowski CA, Waller MN, Guidelines Working Group Centers for Disease Control and Prevention (CDC). Updated guidelines for evaluating public health surveillance systems: recommendations from the Guidelines Working Group. MMWR Recomm Rep. 2001;50(RR-13):1–35.PubMedGoogle Scholar