Computerized surveillance of adverse drug reactions in hospital: Implementation

Department of Medicine, Hadassah University Hospital, Jerusalem, Israel.
European Journal of Clinical Pharmacology (Impact Factor: 2.97). 02/1999; 54(11):887-92. DOI: 10.1007/s002280050571
Source: PubMed


To implement and measure the effects of automatic computerized laboratory signals (ALS) as a detection support tool of adverse drug reactions (ADRs) in hospital.
This was a prospective observational study of a total of 192 patients (199 sequential medical admissions) during a 2-month period in a 34-bed medical ward at the Hadassah University Hospital, Jerusalem, Israel. The study involved the routine (daily) distribution to staff physicians of lists of automatic signals generated from computerized laboratory data as potential indicators of ADRs. Patient charts were reviewed by the clinical pharmacology team for ADRs and to see whether these were recognized by the staff physicians.
Seventy-one ADRs were detected in 64 of the 199 (32%) admissions. Twenty-seven per cent of the ADRs were serious, 9% of the admissions were due to ADRs. Two hundred and ninety-five ALS were generated involving 69% of the admissions. Sixty-one per cent of the ADRs were identified by ALS. ALS were present in 58% of the ADR negative admissions. Eighty-five per cent of the ADRs were recognized as such and 19% of the ALS-positive ADRs were not recognized by the staff physicians.
The routine implementation of ALS doubled the number of ADRs recognized by the physicians while patients were hospitalized in the medical ward. The use of the system appeared valid, simple and potentially cost-effective.

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    • "and reasons for discontinuation can be included in the questionnaire. Such projects have proved useful for the study of acute and relatively common ADRs (Schumock et al., 1995; Levy et al., 1999; Van Puijenbroek et al., 2002; Coulter, 2002). ADRs and events have a considerable impact not only on the health of the population but also on health care costs; they account for 5% of all hospital admissions, occur in 10–20% of inpatients, cause death in 0.1% of medical and 0.01% of surgical inpatients and increase the costs of patient care (Meyboom et al., 2002; Pirmohamed et al., 1998). "
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    Interdisciplinary toxicology 03/2013; 6(1):41-6. DOI:10.2478/intox-2013-0008
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    • "st of 86 million euros.(Leendertse et al., 2008) Medication errors occur due to the rapidly increasing complexity of evidence based medicine and error sensitivity of healthcare.(James, 2002) Physicians need to take many drug-and patient specific characteristics into account and literature shows that this is often omitted or not recognized in time.(Levy et al., 1999;Schiff et al., 2003;Denekamp, 2007) Beyond reminders, CDSS can integrate clinical data to support professionals managing an increasingly complex practice environment.(James, 2001) Integration of these specific parameters is necessary to guide patients through the complete clinical pathway from anamnesis to evaluation and fine-tuning of "

    Efficient Decision Support Systems - Practice and Challenges in Biomedical Related Domain, 09/2011; , ISBN: 978-953-307-258-6
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    • "34 bed medical ward in teaching hospital Jha et al., 1998 39 726 bed tertiary teaching hospital Raschke et al., 1998 46 650 bed community teaching hospital Levy et al., 1999 18 34 bed medical ward in teaching hospital Dormann et al., 2000 41 9 bed medical ward in a teaching hospital Brown et al., 2000 48 238 bed Veterans Administration Medical Center Jha et al., 2001 42 726 bed tertiary care teaching hospital Thuermann et al., 2002 43 86 bed neurology department in teaching hospital Dormann et al., 2004 44 29 bed gastroenterology ward in teaching hospital Silverman et al., 2004 47 726 bed tertiary care teaching hospital Hartis et al., 2005 "
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