Incidence, Preventability, and Impact of Adverse Drug Events (ADEs) and Potential ADEs in Hospitalized Children in New Zealand

2009 ◽  
Vol 11 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Desireé L. Kunac ◽  
Julia Kennedy ◽  
Nicola Austin ◽  
David Reith
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bettina Habib ◽  
Robyn Tamblyn ◽  
Nadyne Girard ◽  
Tewodros Eguale ◽  
Allen Huang

Abstract Background Administrative health data are increasingly used to detect adverse drug events (ADEs). However, the few studies evaluating diagnostic codes for ADE detection demonstrated low sensitivity, likely due to narrow code sets, physician under-recognition of ADEs, and underreporting in administrative data. The objective of this study was to determine if combining an expanded ICD code set in administrative data with e-prescribing data improves ADE detection. Methods We conducted a prospective cohort study among patients newly prescribed antidepressant or antihypertensive medication in primary care and followed for 2 months. Gold standard ADEs were defined as patient-reported symptoms adjudicated as medication-related by a clinical expert. Potential ADEs in administrative data were defined as physician, ED, or hospital visits during follow-up for known adverse effects of the study medication, as identified by ICD codes. Potential ADEs in e-prescribing data were defined as study drug discontinuations or dose changes made during follow-up for safety or effectiveness reasons. Results Of 688 study participants, 445 (64.7%) were female and mean age was 64.2 (SD 13.9). The study drug for 386 (56.1%) patients was an antihypertensive, and for 302 (43.9%) an antidepressant. Using the gold standard definition, 114 (16.6%) patients experienced an ADE, with 40 (10.4%) among antihypertensive users and 74 (24.5%) among antidepressant users. The sensitivity of the expanded ICD code set was 7.0%, of e-prescribing data 9.7%, and of the two combined 14.0%. Specificities were high (86.0–95.0%). The sensitivity of the combined approach increased to 25.8% when analysis was restricted to the 27% of patients who indicated having reported symptoms to a physician. Conclusion Combining an expanded diagnostic code set with e-prescribing data improves ADE detection. As few patients report symptoms to their physician, higher detection rates may be achieved by collecting patient-reported outcomes via emerging digital technologies such as patient portals and mHealth applications.


Author(s):  
Lisa Kremer ◽  
David Reith ◽  
Natalie J. Medlicott ◽  
Mary J. Sime ◽  
Liza Edmonds ◽  
...  

Objective This study was aimed to determine mydriatic regimen(s) used in neonatal units in Aotearoa New Zealand (NZ) and Australia and to estimate the frequency of adverse drug events following mydriatic administration in preterm neonates. Study Design A cross-sectional survey was sent to neonatal nursing staff listed in the Australian and New Zealand Neonatal Network contact list. Participants were asked to state what mydriatic regimen they use, and to estimate the frequency of adverse drug events when eye drops were administered for retinopathy of prematurity eye examinations (ROPEE). Results Thirteen different mydriatic regimens were identified; phenylephrine 2.5% and cyclopentolate 0.5% (1 standard drop of each) was the most commonly used regimen. Two of the regimens exceeded adult doses and five regimens included a mydriatic that is equivalent to an adult dose. Following mydriatic instillation, the three most common adverse effects were apnea, tachycardia, and periorbital pallor. Conclusion Low-concentration single-microdrop regimens are currently in use and resulting in successful ROPEE, yet doses exceeding adult doses are in use throughout Aotearoa NZ and Australian units. We know from this dataset that neonates are experiencing unwanted and potentially preventable, adverse effects associated with mydriatics, and every effort should be made to minimize this risk. Key Points


2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Mohammed Gebre Dedefo ◽  
Abraham Haileamlak Mitike ◽  
Mulugeta Tarekegn Angamo

2021 ◽  
Author(s):  
Hiran Thabrew ◽  
Christa Fouché ◽  
Laura Ann Chubb ◽  
Stacey Yates ◽  
Harshali Kumar ◽  
...  

BACKGROUND Hospitalized children and young people can feel disconnected from their peers and families, which can in turn predispose them to psychological problems including anxiety and depression. Immersive Reality Experiences (IRE) technology, recently developed by the New Zealand Patience Project Charitable Trust may help to overcome these issues. IRE technology uses immersive 360-degree live-streaming and a virtual reality (VR) headset to enable hospitalized children and young people to connect with cameras located in either their school or home environment. OBJECTIVE This trial was undertaken to 1) quantitatively evaluate the effectiveness of IRE technology in reducing social isolation and improving social connectedness and wellbeing using validated outcome measures and 2) expand qualitative findings from a previous smaller ‘proof of concept’ trial to ascertain the views of hospitalized New Zealand children and young people, their caregivers and teachers regarding IRE technology. METHODS An open trial of IRE technology was conducted between December 2019 and December 2020 and included 19 New Zealand children and young people aged 13-18, who had been hospitalized at Starship Hospital, a specialist pediatric hospital in Auckland, for at least 2-weeks. All participants completed the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), an abbreviated version of the Social Connectedness Scale (SCS) and the Social Inclusion Scale (SIS) and at baseline. Ten participants used IRE technology as often as they wished over a 6-week period and completed post-intervention measures. Semi-structured interviews with a subset of participants, caregivers and teachers were conducted immediately post-intervention. RESULTS Participants reported improvements in social inclusion (mean change 3.9, SD 2.8, p 0.057), social connectedness (mean change 14.2, SD 10.0, p 0.002) and well-being (mean change 5.7, SD 4.0, p 0.003). Key themes from interviews with participants, caregivers and teachers were: the importance of support for using IRE technology, connecting vs connectedness, choice and connection, and the value of setting it up and getting it right. A number of recommendations for improving connectedness via IRE and related technology were also provided. CONCLUSIONS IRE technology can improve the social inclusion, social connectedness and well-being of hospitalized New Zealand children and young people. With some technological modifications and simplified implementation, IRE technology could become part of standard care and support hospitalized children and young people in New Zealand and elsewhere to sustain family and peer cohesion, experience fewer psychological problems and more easily return to normal life following completion of treatment. CLINICALTRIAL This study has been registered with the Australian New Zealand Clinical Trials Network Registry: ACTRN12619000252112p


2013 ◽  
Vol 102 (9) ◽  
pp. e419-e423 ◽  
Author(s):  
Vesal Moeeni ◽  
Tony Walls ◽  
Andrew S Day

Author(s):  
Santosh B. Godbharle ◽  
Sudhir L. Padwal

Background: The objectives of the study were to evaluate incidence and preventability of adverse drug events (ADEs) and potential ADEs and to analyse preventable events to develop prevention strategies.Methods: The study was retrospective observational study conducted at a rural tertiary care hospital at Maharashtra, for 12 months. Patients of both gender and all age group were included in the study. These entire adverse drug reactions were reported either by the PVPI assistance and/or hospital staff and their severity and causality assessments was performed as per Naranjo’s and Hartwig’s assessment criteria respectively. Data was analyzed by using Microsoft Excel.Results: There were total 256 ADR (adverse drug reactions) were reported in 12 months from January 2018 to December 2018 in various departments of the study center. Most of the adverse drug reactions were reported among age group of 21–40 years patients. Rash and itching (69) were most commonly reported ADR’s. ART (31.25%), antibiotics (28.90%) were reported to induce maximum number of ADRs. Most of the adverse drug reactions were possible (194, 75.78%) and mild (208, 81.25%) in nature.Conclusions: The antibiotics, ART drugs were most common drugs to reported ADRs. The commonly reported reactions were rash and itching.


2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Tesfahun Chanie Eshetie ◽  
Bisrat Hailemeskel ◽  
Negussu Mekonnen ◽  
Getahun Paulos ◽  
Alemayehu Berhane Mekonnen ◽  
...  

2020 ◽  
Vol 34 (5) ◽  
pp. 532-539
Author(s):  
Freja Karuna Hemmingsen Sørup ◽  
Robert Eriksson ◽  
David Westergaard ◽  
Jesper Hallas ◽  
Søren Brunak ◽  
...  

Background: Understanding sex differences in adverse drug reactions to drugs for psychosis could potentially guide clinicians in optimal drug choices. Aims: By applying a text-mining approach, this study aimed to investigate the relationship between drugs for psychosis and biological sex differences in frequencies and co-occurrences of potential adverse drug events (ADEs). Methods: Electronic patient records of a psychiatric population (1427 men and 727 women) were text mined for potential ADEs. The relative risk of experiencing specific ADEs and co-occurrence of ADEs were calculated for each sex. Results: Findings included 55 potential ADEs with significantly different frequencies between the two sexes. Of these, 20 were more frequent in men, with relative risks of 1.10–7.64, and 35 were more frequent in women, with relative risks of 1.19–21.58. Frequent potential ADEs were psychiatric symptoms, including sexual dysfunction and disturbances in men, and gastrointestinal symptoms, suicidal and self-injurious behaviour and hyperprolactinemia-related events in women. Mention of different hyperprolactinemia-related ADEs often co-occurred in female patients but not in male patients. Conclusion: Several known sex-related ADEs were identified, as well as some previously not reported. When considering the risk–benefit profile of drugs for psychosis, the patient’s sex should be considered.


2020 ◽  
Vol 25 (4) ◽  
pp. 295-302
Author(s):  
Marumi Yamamoto ◽  
Yoshinori Ohta ◽  
Mio Sakuma ◽  
Chisa Matsumoto ◽  
Takeshi Morimoto

OBJECTIVES To identify differences in the incidence and severity of adverse drug events (ADEs) due to CNS depressant drugs among pediatric patients with and without surgery. METHODS The Japan Adverse Drug Events Study was a cohort study enrolling pediatric inpatients. Potential ADEs were identified by onsite review of medical charts, incident reports, and prescription queries. Two independent physicians classified ADEs and severity. We compared the incidence and characteristics of ADEs between pediatric patients with surgery (surgery group) and without surgery (non-surgery group). We evaluated severity of ADEs due to CNS depressant drugs among both groups. RESULTS We enrolled 944 patients, 234 in surgery group and 710 in non-surgery group. A total of 480 ADEs due to any drugs occurred in 225 patients. Among 81 ADEs due to CNS depressant drugs, 42 ADEs were in surgery group, whereas 39 were in non-surgery group. The risk of fatal or life-threatening ADEs due to CNS depressant drugs was significantly higher than other drugs (12% vs. 2%, p < 0.001). In the surgery group, anesthetics led to 2 fatal or life-threatening, 8 serious, and 30 significant ADEs, whereas in the non-surgery group anesthetics led to 2 fatal or life-threatening, 5 serious, and 4 significant ADEs. Anesthetics were higher risk in the non-surgery group (p = 0.049). CONCLUSIONS The risks of fatal and life-threatening ADEs were significantly higher with CNS depressant drugs than other drugs. Pediatric patients without surgery have higher risks of fatal or life-threatening ADEs due to anesthetics than those with surgery.


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