title: Adverse drug event rates in six community hospitals and the potential impact of computerized physician order entry for prevention.
abstract: BACKGROUND
  Medications represent a major cause of harm and are costly for hospitalized patients, but more is known about these issues in large academic hospitals than in smaller hospitals.
  
  
  OBJECTIVE
  To assess the incidence of adverse drug events (ADEs) in six community hospitals.
  
  
  METHODS
  Multicenter, retrospective cohort study.
  
  
  METHODS
  Six Massachusetts community hospitals with 100 to 300 beds.
  
  
  METHODS
  From 109,641 adult patients hospitalized from January 2005 through August 2006, a random sample of 1,200 patients was drawn, 200 per site.
  
  
  METHODS
  ADEs and preventable ADEs.
  
  
  METHODS
  Presence of an ADE was evaluated using an adaptation of a trigger instrument developed by the Institute for Health Care Improvement. Independent reviewers classified events by preventability, severity, and potential for preventability by computerized physician order entry (CPOE).
  
  
  RESULTS
  A total of 180 ADEs occurred in 141 patients (rate, 15.0/100 admissions). Overall, 75% were preventable. ADEs were rated as serious in 49.4% and life threatening in 11.7%. Patients with ADEs were older (mean age, 74.6 years, p < 0.001), more often female (60.3%, p = 0.61), and more often Caucasian (96.5%, p < 0.001) than patients without ADEs. Of the preventable ADEs, 81.5% were judged potentially preventable by CPOE.
  
  
  CONCLUSIONS
  The incidence of ADEs in these community hospital admissions was high, and most ADEs were preventable, mostly through CPOE. These data suggest that CPOE may be beneficial in this setting.
authors.affiliation: Division of General Internal Medicine, Brigham and Women's Hospital, Brigham Circle, 1620 Tremont St., 3rd Floor, Boston, MA, 02120-1613, USA.
authors.forename: Balthasar L
authors.initials: BL
authors.lastname: Hug
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Witkowski
authors.forename: Colin M
authors.initials: CM
authors.lastname: Sox
authors.forename: Carol A
authors.initials: CA
authors.lastname: Keohane
authors.forename: Diane L
authors.initials: DL
authors.lastname: Seger
authors.forename: Catherine
authors.initials: C
authors.lastname: Yoon
authors.forename: Michael E
authors.initials: ME
authors.lastname: Matheny
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000639:trends*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D005260:Female; D006764:Hospitals, Community / Q000379:methods / Q000639:trends*; D006801:Humans; D008297:Male; D050316:Medical Order Entry Systems / Q000639:trends*; D008508:Medication Errors / Q000517:prevention & control / Q000639:trends; D008510:Medication Systems, Hospital / Q000639:trends*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult