Investigation into the reasons for preventable drug related admissions to a medical admissions unit: observational study.
OBJECTIVE
To describe the drugs and types of medicine management problems most frequently associated with preventable drug related admissions to an acute medical admissions unit.


METHODS
Observation study.


METHODS
Medical admissions unit in a teaching hospital in Nottingham, UK.


METHODS
4093 patients seen by pharmacists on the medical admissions unit between 1 January and 30 June 2001.


METHODS
Proportion of admissions that were drug related and preventable, classification of the underlying causes of preventable drug related admissions, and identification of drugs most commonly associated with preventable drug related admissions.


RESULTS
Of the admissions seen by pharmacists, 265 (6.5%) were judged to be drug related and 178 (67%) of these were judged to be preventable. Preventable admissions were mainly due to problems with prescribing (63 cases (35%)), monitoring (46 cases (26%)), and adherence to medication (53 cases (30%)). The drugs most commonly implicated were NSAIDs, antiplatelets, antiepileptics, hypoglycaemics, diuretics, inhaled corticosteroids, cardiac glycosides, and beta-blockers.


CONCLUSIONS
Potentially preventable drug related morbidity was associated with 4.3% of admissions to a medical admissions unit. In 91% of cases these admissions were related to problems with either prescribing, monitoring, or adherence.
Howard
R L
RL
Division of Primary Care, School of Community Health Sciences, University Hospital, Nottingham NG7 2UH, UK. Rachel.howard@broxtowehucknall-pct.nhs.uk
Avery
A J
AJ
Howard
P D
PD
Partridge
M
M
D016907:Adverse Drug Reaction Reporting Systems; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D016903:Drug Monitoring / Q000592:standards; D011307:Drug Prescriptions / Q000145:classification; D017723:Drug Utilization Review; D064420:Drug-Related Side Effects and Adverse Reactions; D004739:England; D006302:Health Services Research; D006757:Hospital Units / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008485:Medical Audit; D008508:Medication Errors / Q000145:classification / Q000517:prevention & control / Q000706:statistics & numerical data*; D015588:Observer Variation; D010343:Patient Admission; D004364:Pharmaceutical Preparations / Q000145:classification; D010607:Pharmacy Service, Hospital; D011320:Primary Health Care / Q000592:standards; D014600:Utilization Review
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004364:Pharmaceutical Preparations