Adverse drug events

We are a multi-disciplinary team focusing on the prevention of adverse drug events through improved documentation and communication of adverse drug event information between health care providers.

Background:

• Adverse drug events are unintended and harmful events resulting from medication use, and result in 276,000 emergency department visits, 102,000 admissions, and 4,514 deaths in BC annually.
• 33% of adverse drug events are repeat events that are due to unintentional re-exposures to medications that previously caused harm. This happens because healthcare providers are often unaware of prior adverse drug events when prescribing. 75% of repeat events can be prevented by enabling clinicians to communicate adverse drug events to other care providers and health sectors, and community pharmacies.
• Our research group has developed a software application, called ActionADE, which will allow health care providers to document and communicate patient-specific adverse drug event information in a user-friendly, standardized manner.
• ActionADE can be hyperlinked to any electronic medical record in the province, allowing care providers to capture patient-level information and to generate a brief standardized report. In the future, reports will be linked to a patient’s PharmaNet profile to close crucial information gaps between health professionals at different locations of care by allowing standardized reports to be communicated to other hospitals, general practitioners, and all community pharmacies.

Work to date:

• We have completed a systematic review of existing electronic reporting systems worldwide to identify a set of all possible data fields related to documenting adverse drug event information. We conducted over 265 hours of observations in varied care settings (pharmacies, hospitals) to understand clinicians’ workflow related to adverse drug event diagnoses and treatment, challenges associated with reporting these events, and how patient-level data may be used at the point-of-care to affect prescribing and dispensing decisions. These activities informed the design of a prototype reporting system called ActionADE and its integration strategy.
• We have refined our prototype in response to feedback received during workshops with various clinician groups, which was then pilot tested in a paper-based format among clinical pharmacists working in the emergency departments of two acute care hospitals.  We have partnered with a technology company build the interface based on our work to date.
• We have incorporated patient engagement strategies in order to meet the diverse needs of relevant patient groups. We currently have three patient partners working on the team and have previously conducted a series of focus groups among different patient groups to understand preferences of information sharing and privacy in the context of adverse drug events.
• We have created a steering committee with representation from all relevant stakeholders, including the provincial Ministry of Health and health authority,  to foster collaboration and guide decisions related to implementation and scaling.

Research Team:

Co-PI: Corinne Hohl
Research Coordinators: Amber Cragg, Jeffrey Hau, Vi Ho and Caris Tze
Post-doctoral Fellow: Erica Lau