药物不良反应概论--培训课件.pptVIP

PEM的优点 黄卡系统有益而必要的补充 迅速从所有处方监测药物的医生处获得报告； 非干预性, 对医生处方习惯、处方药物无任何影响； 对所发生的药物不良反应高度敏感； 可探测潜伏期较长的不良反应； 相对于前瞻性队列研究费用较少； What we see is “Tip of the unreported iceberg” 29 29 Thanks! Hospital admissions resulting from preventable adverse drug reactions. McDonnell PJ, Jacobs MR. Source School of Pharmacy, Temple University, Philadelphia, PA 19140-5101, USA. pmcdonne@unix.temple.edu Abstract BACKGROUND: Adverse drug reactions (ADRs) are a significant cause of hospital admissions. These events can lead to significant morbidity and mortality and financial costs. ADRs that may be preventable might be considered a form of medication error. OBJECTIVE: To assess the potential preventability of ADRs directly related to a patients hospital admission. METHODS: A retrospective chart review of 437 ADRs occurring during an 11-month period was conducted at a university hospital. A subset of these events leading to hospital admissions was identified for further review. Those that resulted in admission were further examined to determine probability of causality, severity, and preventability. RESULTS: Over 11 months, 158 ADRs were directly related to hospital admission. The relationship of these admissions to drug exposure was determined to be probable or highly probable in 154 (97.4%) of these cases. From this group, 96 (62.3%) of these events were considered potentially preventable, with 23 (24%) considered severe to life-threatening. Characteristics associated with these ADRs included documentation of a toxic drug concentration or abnormal laboratory value (80%), inadequate monitoring of a patients drug therapy (67%), inappropriate dose (51%), patient noncompliance (33%), drug-drug interaction (26%), contraindication to therapy (3%), and documented allergy (1%). These ADRs resulted in 595 hospital days, with an average length of stay of 6.1 days. CONCLUSIONS: ADRs leading to hospital admissions are often preventable. Approximately 25% of these events were serious to life-threate