title: Assessment of adverse drug event recognition by emergency physicians in a French teaching hospital.
abstract: OBJECTIVE
  The frequency and the severity of drug-related visits in emergency department (ED) make the improvement of adverse drug event (ADE) recognition a crucial issue. As part of a research project aiming to improve the diagnosis and the management of ADEs in ED, the authors conducted a pilot study whose primary objective was to assess ADE recognition by emergency physicians.
  
  
  METHODS
  The patients presenting to the ED were included at randomised time periods between 1 October 2007 and 31 March 2008 in this prospective cross-sectional study. The primary outcome was the frequency of ADEs that were attributed to a medication-related problem by the emergency physician.
  
  
  RESULTS
  A total of 423 patients met the inclusion criteria, of which 95 experienced an ADE (22.5%; 95% CI 18.6% to 26.7%). Emergency physicians correctly attributed 33 of these cases (34.7%; 95% CI 25.3% to 45.2%) to a medication-related problem. Of the 28 cases in which the ADE was considered as a 'direct drug effect' (29.5%; 95% CI 20.6% to 39.7%), 16 were correctly identified by emergency physicians (57.1%; 95% CI 37.2% to 75.5%). Of the 67 cases in which the ADE was considered as a 'drug involvement in a multifactorial pathological condition' (70.5%; 95% CI 60.3% to 79.4%), 17 were correctly attributed (25.4%; 95% CI 15.5% to 37.5%).
  
  
  CONCLUSIONS
  ADEs are frequent in EDs and are not well recognised by emergency physicians, especially when the drug is involved in a multifactorial pathological condition.
authors.affiliation: Faculté de Médecine, 1 rue Gaston Veil, Nantes 44035, France.
authors.forename: Lucien
authors.initials: L
authors.lastname: Roulet
authors.forename: Françoise
authors.initials: F
authors.lastname: Ballereau
authors.forename: Jean-Benoît
authors.initials: JB
authors.lastname: Hardouin
authors.forename: Anne
authors.initials: A
authors.lastname: Chiffoleau
authors.forename: Leïla
authors.initials: L
authors.lastname: Moret
authors.forename: Gilles
authors.initials: G
authors.lastname: Potel
authors.forename: Nathalie
authors.initials: N
authors.lastname: Asseray
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis*; D004635:Emergency Medicine / Q000592:standards*; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D005602:France; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies