Medicines implicated in over 6 per cent of acute hospital admissions
Patient admissions to an acute medical unit in Nottingham over a six-month period were related to medicines in over 6 per cent of cases and of these, two-thirds were preventable, a study has shown (Quality and Safety in Health Care 2003;12:280).
The authors of the research believe the preventable drug-related admissions
were predictable, raising concerns about the level of medicines management
in primary care.
Based on their findings, they suggest that it may be worth focusing on
preventing morbidity associated with non-steroidal anti-inflammatory
drugs and low-dose aspirin. They recommend that patients at high risk
of gastrointestinal bleeds are monitored and that general practitioners
prescribe ulcer-healing drugs at the same time to prevent adverse effects.
The study involved 4,093 patients admitted to the medical admissions
unit at Queen’s Medical Centre, Nottingham, who were seen by a
pharmacist. Drug-related morbidity was judged to be the cause of 265
(6.5 per cent) of these admissions and 178 (67 per cent) of these were
thought to be preventable.
In addition to NSAIDs and anti-platelets, beta-blockers, antiepileptics,
diuretics, sulphonylureas, digoxin, inhaled corticosteroids, nitrates
and insulin were implicated in the drug-related admissions. Most were
attributed to problems with prescribing (35 per cent), monitoring (26
per cent) and patient adherence to their regimens (30 per cent).
Veronica Wray of PharmacyHealthLink told The Journal the research highlighted
the need for GPs to work more closely with pharmacists.
“I think that all the pharmacy organisations would agree on this issue.
There’s a real need for local practitioners to work together for the benefit
of patients and to forget all the professions’ territorial behaviour. The
push for this must come at an undergraduate level,” she said.
The finding that 67 per cent of drug-related hospital admissions could have been
prevented is tragic, she added. “A huge percentage like this, multiplied
nation wide, means millions of pounds wasted every week plus wards full of people
who shouldn’t be there.” |
