title: Adverse drug events in hospitalized cardiac patients.
abstract: Little information is available concerning adverse drug events (ADEs) in cardiac patients. Therefore, the investigators report the results of cardiac patients in an ADE surveillance program, with the intent of reducing the frequency of future events. All reported adverse drug reactions and medication errors in cardiac patients over a 5-year period at Brigham and Women's Hospital were reviewed. There were 547 ADEs in cardiac patients, a rate of 1.9 events for every 100 patient admissions. Preventable ADEs most often occurred during medication administration (34.2%), with wrong rate or frequency of medication administration the most widespread event. Cardiovascular agents (29.8%), anticoagulants (28.5%), and antimicrobial agents (10.8%) were the most common drug classes associated with ADEs. Injury or prolonged hospitalization occurred in 5.3% of patients. ADEs occurred most frequently on the admission day, on weekdays, and in the early morning hours. Peak frequencies of ADEs coincided with nursing shift changes. In conclusion, ADEs occur often in hospitalized cardiac patients and affect 2 of every 100 patient admissions. Given the high percentage of ADEs associated with drug administration, more resources should be directed at this step of medication use. Focusing interventions around nursing shift changes may further enhance preventive strategies.
authors.affiliation: Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Fanikos
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Cina
authors.forename: Steven
authors.initials: S
authors.lastname: Baroletti
authors.forename: Karen
authors.initials: K
authors.lastname: Fiumara
authors.forename: Lina
authors.initials: L
authors.lastname: Matta
authors.forename: Samuel Z
authors.initials: SZ
authors.lastname: Goldhaber
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000925:Anticoagulants / Q000009:adverse effects; D001900:Boston; D002317:Cardiovascular Agents / Q000009:adverse effects; D017723:Drug Utilization Review; D064420:Drug-Related Side Effects and Adverse Reactions; D006331:Heart Diseases / Q000188:drug therapy*; D006760:Hospitalization; D006785:Hospitals, University / Q000592:standards / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008508:Medication Errors / Q000706:statistics & numerical data*; D009741:Nursing Staff, Hospital / Q000600:supply & distribution; D010561:Personnel Staffing and Scheduling; D013997:Time Factors
chemical_list: D000925:Anticoagulants; D002317:Cardiovascular Agents