Lessons from a patient partnership intervention to prevent adverse drug events.
BACKGROUND
Patient safety 'best practices' that call for patient participation to prevent adverse drug events have not been rigorously evaluated.


OBJECTIVE
To consider lessons learned from a patient partnership intervention to prevent adverse drug events among medical in-patients.


METHODS
Prospective randomized, controlled pilot trial.


METHODS
Boston teaching hospital. Patients. Two hundred and nine adult in-patients on a general medicine unit.


METHODS
Intervention patients (n = 107) received drug safety information and their medication list; controls (n = 102) received drug safety information only. Measurements. Adverse drug events and close-call drug errors were identified using chart review and incident reports from nurses, pharmacists, and physicians. Patients and clinicians were surveyed about the intervention.


RESULTS
In 1053 patient-days at risk, 11 patients experienced 12 adverse drug events and 16 patients experienced 18 close calls. There was a non-significant difference between intervention patients and controls in survey responses and in the adverse drug event rate (8.4% versus 2.9%, P = 0.12) and close-call rate (7.5% versus 9.8%, P = 0.57). Eleven percent of patients were aware of drug-related mistakes during the hospitalization. Among nurse respondents, 29% indicated that at least one medication error was prevented when a patient or family member identified a problem.


CONCLUSIONS
Partnering with in-patients to prevent adverse drug events is a promising strategy but requires further study to document its efficacy.
Weingart
Saul N
SN
Center for Patient Safety, Dana-Farber Cancer Institute, Boston, MA, USA. saul_weingart@dfci.harvard.edu
Toth
Maria
M
Eneman
Jonathan
J
Aronson
Mark D
MD
Sands
Daniel Z
DZ
Ship
Amy N
AN
Davis
Roger B
RB
Phillips
Russell S
RS
D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D001900:Boston; D003625:Data Collection; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D008875:Middle Aged; D010358:Patient Participation / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies