March 10, 2020
Understanding Medication Adverse Effects and How Healthcare Data Management Can Provide Proactive Prevention
Adverse Drug Reactions vs. Adverse Drug Events – Detect and Avoid for Patient Safety
We are experiencing a health craze. Everybody is becoming health conscious and there is an abundance of herbs, supplements, lotions, etc. that people are using in their quest to rid themselves of, and prevent, ailments.
In addition, there are numerous prescription medications (almost 6,800) and countless over-the-counter drugs available in the US market. The use of so many substances in health care opens the door to possible interactions between substances, resulting in medication adverse effects. In the clinical space, terms such as adverse drug events (ADEs) and adverse drug reactions (ADRs) are used to describe some of the possible medication adverse effects that can result from drug use. But does the average person understand the meaning of these terms?
An adverse drug event (ADE) is defined as “an injury resulting from medical intervention related to a drug.” An ADE results from harms caused directly by the drug itself and include medication errors, ADRs, overdoses, and allergic reactions. An ADR, on the other hand, is a harmful and unintended response to a drug at normal doses and during normal use.
The Office of Disease Prevention and Health Promotion, part of the US Department of Health and Human Services, has named ADE prevention as an important patient safety priority in its National Action Plan for Adverse Drug Event Reporting. It noted that ADEs accounted for an estimated one-third of hospital adverse events and approximately 280,000 hospital admissions annually. The ADE Action Plan was established to coordinate multiple stakeholders and align Federal efforts in identifying common, preventable, and measurable ADEs that may result in significant patient harm. The goal is to jointly work towards reducing patient harm from these specific identified ADEs nationally.
Three types of ADEs were selected as the high-priority targets of the ADE Action Plan as they were identified as being common, clinically significant, preventable, and measurable. These are:
- Anticoagulants: primary ADE of concern – bleeding
- Diabetes agents: primary ADE of concern – hypoglycemia
- Opioids: primary ADE of concern – accidental overdoses/over-sedation/respiratory depression
The World Health Organization lists has reported that as many as 4 in 10 patients globally are harmed in primary and outpatient health care. Up to 80% of harm is preventable. The most detrimental errors are related to diagnosis, prescription and the use of medicines. As such, healthcare organizations are urged to utilize the ADE Action Plan and implement strategies to prevent medication adverse effects, especially from the three priority types of ADEs identified. Healthcare data management and healthcare technology can play a major role in this regard, and those organizations that proactively use healthcare technology to detect ADEs will be a step ahead in preventing them. Some ways in which healthcare data management and healthcare technology can be used in ADE detection and prevention include:
- Electronic exchange of health information, such as laboratory results and care (e.g., discharge) summaries. This can help to improve communication among the care team as a patient passes from one team to the next.
- Interoperability between laboratory and pharmacy systems to help prevent medication errors and medication adverse effects.
- Utilize electronic health records (EHRs) and patient engagement tools to provide patient-specific data that can inform appropriate clinical decisions by providers. EHRs and patient engagement tools can also provide clinical reminders and templates to prompt and facilitate recommended clinical practices. This could result in improvements in assessment, documentation, and collaborative treatment planning for patient risk factors and aberrant behaviors.
- Leverage EHR Meaningful Use requirements by incorporating Quality Measures specific to the three types of ADEs identified in the ADE Action Plan.
ADEs can also be prevented by improving patient compliance with their medication regimen. Incorporating remote monitoring solutions such as automated medication dispensers with reminders can improve patient compliance and also prevent potential overdoses especially in seniors with memory problems.