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    Adverse Drug Events – Screening & Diagnosis

    Other, Toxicology

    Last Updated Jan 17, 2021
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    Context

    • Adverse drug events are unintended and harmful events related to medication use or misuse.
    • Adverse drug events (ADE) cause or contribute to 1 in 9 emergency department presentations in Canada, and are associated with poor patient outcomes.1
    • Emergency physicians do not recognize 40-50% of patients presenting with ADEs2 and the ADE either worsens, or recurs when continues or restarts the culprit medication.
    • Emergency departments have insufficient clinical pharmacists to complete medication reviews in all incoming patients to identify adverse drug events.
    • Many patients have presentations that are clearly not related to medication use (e.g., acute appendicitis) and do not require a medication review.

    Diagnostic Process

    This simple and validated clinical decision rule can identify 90% of patients with adverse drug events. Those patients identified as “high-risk” by the rule should have a detailed examination of their medications, to rule out adverse drug events.

    •  a change includes stopping, adding, replacing or changing the dose

    Quality Of Evidence?

    Justification

    • The ADE rule above has been derived and validated prospectively in four centres in British Columbia and Ontario, including in one community hospital.3 4
    • When implemented in three hospitals in the BC Lower Mainland, pharmacist-led medication review resulted in a 10% reduction in median length of hospital stay.5
    Moderate

    Related Information

    Reference List

    Relevant Resources

    RELEVANT CLINICAL RESOURCES

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    RELEVANT RESEARCH IN BC

    Preventing Adverse Drug Events

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