Medication errors send thousands to
VANCOUVER – Almost 25% of patients
admitted to the internal-medicine ward of British Columbia’s largest
hospital are there because of sickness brought on by adverse drug
reactions, a new study has found.
And Peter Zed, a clinical pharmacist and lead researcher, says he
expects similar results from a follow-up look at emergency cases that
has just been completed.
“The healthcare system is bursting at the seams,” commented Dr. Zed to
the National Post. “I’m sure the hospital doesn’t need 25% of their
medicine patients being there because of drug misadventure. Just looking
at the preventable group, that’s a big population: one in five, one in
six patients whose admissions maybe could be avoided.”
The authors recommend better scrutiny of patients throughout the
healthcare system to ensure they are taking the right drug and using it
A landmark 2004 study estimated the extent of medical errors that
afflict patients once they are inside hospitals but did not address
problems that send people there in the first place.
Experts have long known that medication mishaps generate considerable
business for healthcare facilities; the study at Vancouver General
Hospital is the first in Canada to quantify it, said Dr. Zed, a clinical
There is no reason the findings, published recently in the journal
“Pharmacotherapy”, could not be extended to hospitals across Canada, he
Sharon Sholzberg-Gray, president of the Canadian Healthcare Association,
which represents most of Canada’s hospitals, said drug use could be made
much safer with an electronic medical record system, which would provide
easier access to all of a patient’s medicines and ailments in one place,
and a beefed-up home-care network whose workers would monitor patient
The researchers at Vancouver General followed 565 patients admitted to
the hospital over a 12-week period in 2005. All were internal-medicine
patients, chosen because they suffered a range of conditions, from heart
disease and diabetes to psychiatric illness.
Unlike similar studies conducted in the United States, patients were
reviewed as they entered the hospital, not retrospectively after they
The researchers found 24% of hospitalizations were drug-related and 72%
of those were preventable.
The most common problems were adverse reactions to a drug, improperly
prescribed medication and “non-compliance,” where a patient forgets to
take their medication or uses it improperly. Most drug problems were
rated mild or moderate, but more than 10 cases were severe and one
Dr. Zed, now at Queen Elizabeth II Hospital in Halifax, recalled one
case in which a woman stopped taking her diuretic and blood-pressure
medications to get better sleep before her granddaughter’s graduation.
She ended up in emergency on graduation day with heart-failure problems.
Other patients might have adverse reactions because their physician did
not prescribe the correct dose for them, he said.
The patients admitted for drug-related problems were predominantly
elderly, had multiple medical problems and took an average of 7.5
prescription and non-prescription medicines.
Dr. Zed said tackling the problem is complex, as it involves the
hospitals that discharge people with a regimen of drug treatment to
follow, pharmacists, family physicians who oversee their care and
prescribe medicine, and home-care services and nursing homes that are
also supposed to monitor patients.
The paper recommends doctors and other healthcare professionals avoid
duplicating drugs, discontinue those that are unnecessary, monitor
kidney function and anticipate drug interactions.
Patients should also be encouraged to use just one pharmacy and report
non-prescription drugs and alternative-health products they take to
their doctors, the study says.