INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE ADVANCE ACCESS ORIGINALLY PUBLISHED ONLINE ON MARCH 13, 2008 International Journal for Quality in Health Care 2008 20(3):192-199; doi:10.This Article All Versions of this Article: 20/3/192 _most recent_ Services Google Scholar PubMed Social Bookmarking DETECTION AND PREVENTION OF MEDICATION MISADVENTURES IN GENERAL PRACTICE KA WAE TAMMY TAM, HUNG KON KWOK, YUEN MAN CECILIA FAN, KWOK BIU TSUI, KWOK KEUNG NG, KING YIP ANTHONY HO, KAM TONG LAU, YUK CHUN CHAN, CHING WAN CHARMAINE TSE AND CHEUK MAN LAU Professional Development and Quality Assurance, Department of Health, Hong Kong BACKGROUND.Drug events are leading categories of iatrogenic patient injury.Of preventive strategies for general practice setting depends on effective detection of events.OBJECTIVE.Aim of the study is topare the strengths and weaknesses of voluntary reporting, chart review and patient survey in measuring medication misadventures in general practice and to analyze the events by severity and preventability, drug groups and patients' and doctors' characteristics, for the formulation of preventive strategies.In the 2-month study period, we applied voluntary report, chart review and patient survey to collect data related to medication misadventures andpared their detection rate.RESULTS.Chart review demonstrated the highest yield for detecting overall medication misadventures (2.Orders), followed by patient survey (1.Orders) and voluntary reporting (0.Chart review and patient survey were better than voluntary reporting in uncovering preventable adverse drug events.Reporting was pivotal in capturing sentinel events.Diuretic, angiotensin-converting enzyme inhibitor, aspirin and non-steroidal anti-inflammatory drugs had caused 82.All adverse drug events.Events were moremon with advanced age of patients, greater number of consultation problems and prescribed drug items.Resources implicated were minimal.We suggested aplementary approach using chart review and voluntary reporting in measuring and monitoring medication misadventures in general practice.Monitoring of the events was necessary for older patients, multiple medical problems and poly-pharmacy and for patients using beta-blocker, diuretic, angiotensin-converting enzyme inhibitor, aspirin or non-steroidal anti-inflammatory drugs on a long-term basis.KEYWORDS: adverse drug event, chart review, medication error, patient survey, voluntary reporting Address reprint requests to: Ka Wae Tammy Tam, Professional Development and Quality Assurance, Department of Health, Hong Kong.Accepted for publication January 18, 2008.Read more Effects and interactions in an environmentally relevant mixture of pharmaceuticals
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