An adverse drug event (ADE), according to the Office of Disease Prevention and Health Promotion, is “an injury resulting from medical intervention related to a drug. This includes medication errors, adverse drug reactions, allergic reactions, and overdoses.”
ADEs happen more often than you think, both in our community and nationwide. A study in the Journal of Patient Safety found that around 13% of 30-day hospital readmissions were caused by ADEs – of those, over 80% were serious, and nearly 93% were preventable. From an outpatient perspective, ADEs account for an estimated 1 million emergency department visits and over 3.5 million physician office visits each year.
This may include patients who were previously in a rehab program for any number of reasons, such as, stroke, pulmonary, cardiac, or wound care. A patient may be on medications for any of these conditions, or perhaps even a condition beyond the reason they were in rehabilitation.
At any rate, there are a few reasons why patients have adverse drug events, common medications that cause them, and finally, ways patients can prevent them in the future. In this article, we’ll explore each of these.
With more than half the US population on a prescription medication, it’s perhaps not surprising that ADEs impact more than 7 million people a year. Many patients are prescribed four or more medications, as well as over-the-counter drugs. The sheer volume of medications being used by U.S. patients creates complex medical scenarios, triggering a growing risk of an ADE. The most common causes of adverse drug events include:
Perhaps the most troubling cause of adverse drug events are those caused by prescription errors. A research study into 30-day hospital readmissions found that half of all readmissions caused by drug events could be attributed to patients being given the wrong prescription. This is particularly the case for diuretics, analgesics, and anti-thrombotics.
For patients taking multiple medications, medication reconciliation is a major issue of concern. The Joint Commission’s report on Hospital National Patient Safety Goals identified medication reconciliation as a top priority. If patients are taking multiple medications, there can be a risk that some of these treatments could interact badly, causing health issues for the patient. This can be particularly problematic when the patient moves from one care setting to another, such as leaving the hospital and entering an outpatient program.
The remaining 50% of ADEs are caused by patient error. Patients may misunderstand their doctor’s instructions, forget how much of a given medicine they have already taken, or mistakenly take too much or too little of their prescription drugs.
Patients may also forget to tell their prescribing physician about all the medications they are taking, resulting in negative side effects from combining two or more incompatible drugs. Finally, some people may simply decide not to take their prescribed medication as their doctor recommended; a study from the Journal of the American Pharmacists Association found that, of the hospital readmissions caused by adverse drug events, nearly 1 in 4 were the result of “non-adherence due to patient choice.”
While an ADE can occur with almost any type of medication, there are a few common ones that often cause issues. These medications include:
With too much insulin, blood sugar levels may go too low; this can cause a number of serious issues, including the potential risk of seizures or a coma. With high blood-sugar levels from too little insulin or medication, patients also are at risk for a coma or other life-threatening conditions when medications are not used correctly over a long period of time.
While adverse drug events are on the rise, there are ways to reduce the risk that you will experience an ADE. Here are a few suggestions:
In many cases, it may be advisable to consider a rehabilitation program. One of the many benefits of a physical rehab program is that your team of rehab professionals will help you manage your medications, keep track of how many medicines you have, and when you should be taking them. They will ensure that your medical regime is appropriate and safe, make sure you are aware of any potential risks and how to minimize them, and provide you with training on how to use your medication properly.
If you’d like to learn more about how the team at Rehab Select can help you manage your medications and avoid adverse drug events, please contact us here or see our website for more information on our rehab programs.