National Level Exploratory Analysis of Hospital Adverse Drug Events Using the ADE Action Plan as a Framework

Nova Southeastern University, Davie, Florida, USA

Objective. This study was conducted to provide a national level analysis of hospital adverse drug events (ADEs) related to anticoagulants, diabetes agents, and opioids. Background. Hospital ADEs comprised the largest category of adverse events with an estimation of one event per patient per day in hospital care. Based on national ADE data, three types of adverse events were common, clinically significant, preventable, measurable, and were selected as high-priority targets of the ADE Action Plan. The targeted medication classes were anticoagulants, diabetes agents, and opioids. Methods. This study was an exploratory, quantitative, retrospective analysis. The National Inpatient Sample database (NIS) was used to explore ADEs yearly number of events (events/year), and ICD-9 codes associated with ADEs were used to identify the study population. Results. The average national events/year of ADEs during 2009-2014 was 44,824/year for anticoagulants, 8,493/year for diabetes agents, and 31,545/year for opioids. However, the number of events/year varied based on patient demographics, payer type and the presence of different comorbidities. For instance, the national number of events/year was higher in Medicare patients among the three medication classes. Meanwhile, females had lower number of events/year due to anticoagulants and diabetes agents, and a higher one for opioids related ADEs (19,450/year vs. 12,089/year). Conclusion. The national yearly number of events of hospital ADEs was highly associated with patients’ factors. Prevention strategies should not be individualized based on the medication only, but on patient’s factors as well. Grants. This study was partially funded by a grant from the Health Profession Division at NSU.