丁香园AV

Adverse drug events (ADEs), unintended harmful events resulting from medication use, are a leading cause of emergency department (ED) visits and hospital admissions.

Research enrolling over 3000 patients in three British Columbia (BC) hospitals suggests that ADEs account for 12% of ED visits, causing over 200,000 ED visits in BC annually, incurring costs of roughly $90,000,000. Of these visits, 70% are preventable and most involve seniors.

There are many reasons ADEs occur. New prescriptions are commonly issued in hospital and often filled before patients can consult their family physician. Medications that have previously caused harm are often redispensed because discontinuation orders are not communicated to PharmaNet (a medication billing system used across BC). Insufficient documentation in PharmaNet often results in unintentional prescribing and dispensing of contraindicated medications, as well as information gaps related to prescribing or patient monitoring for outpatient pharmacists or specialist physicians following up on patients. Conservative estimates suggest 1/3 of preventable ADEs are avoidable by designing new ADE reporting fields in PharmaNet to create a real-time, effective communication link between healthcare sectors. We estimate this platform will prevent over 40,000 ED visits and save $18,000,000 annually (using a cost base of $450/visit). Our project, Pill Talk, will implement and evaluate an ADE reporting platform through PharmaNet, which will integrate into various means of delivery of clinical care and address the need for improved communication of ADEs across locations of care and providers. Pill Talk builds on mature partnerships, extensive end user involvement and an existing prototype to implement and evaluate an enhanced PharmaNet-based ADE reporting platform in BC. The system will also meet emergent reporting requirements for recently passed Bill C-17.