Hospital admissions caused by adverse drug events: an Australian prospective study

The objective of this study is to assess the frequency of adverse drug event-related admissions (ADE-RA) during a prospective medical record review of patients admitted to a metropolitan tertiary referral hospital. Potential ADE-RA cases were identified by examination of case records of randomly selected patients. Cases were assessed by an expert panel to measure study outcomes, which were the frequency (ADEs and ADE-RAs) as well as type, likelihood of causality, severity, avoidability and detection of ADEs. Of the 370 subjects, 59 (16.0%) had a confirmed ADE-RA, with 15 (4.1%) of these serious and preventable. Half the ADEs were detected after the patient had been admitted and most were detected by medical practitioners. Antineoplastics followed by antidiabetic agents were most frequently implicated. Implementing a systems approach that involves multiple strategies, such as improving tertiary-toprimary care information transfer and promoting medication adherence through education programs, is necessary to tackle the problem of avoidable ADE-RAs and the associated cost burden.