Lessons from a patient partnership intervention to prevent adverse drug events
1 Center for Patient Saftey, Dana-Farber Cancer Institute, 2 Stoneman Center for Quality Improvement in General Medicine and Primary Care, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 3 Harvard Medical School, Boston, and 4 University of Vermont College of Medicine, Burlington, USA
Background. Patient safety ‘best practices’ that call for patient participation to prevent adverse drug events have not been rigorously evaluated.
Objective. To consider lessons learned from a patient partnership intervention to prevent adverse drug events among medical in-patients.
Design. Prospective randomized, controlled pilot trial.
Setting. Boston teaching hospital.
Patients. Two hundred and nine adult in-patients on a general medicine unit.
Intervention. Intervention patients (n = 107) received drug safety information and their medication list; controls (n = 102) received drug safety information only.
Measurements. Adverse drug events and close-call drug errors were identified using chart review and incident reports from nurses, pharmacists, and physicians. Patients and clinicians were surveyed about the intervention.
Results. In 1053 patient-days at risk, 11 patients experienced 12 adverse drug events and 16 patients experienced 18 close calls. There was a non-significant difference between intervention patients and controls in survey responses and in the adverse drug event rate (8.4% versus 2.9%, P = 0.12) and close-call rate (7.5% versus 9.8%, P = 0.57). Eleven percent of patients were aware of drug-related mistakes during the hospitalization. Among nurse respondents, 29% indicated that at least one medication error was prevented when a patient or family member identified a problem.
Conclusion. Partnering with in-patients to prevent adverse drug events is a promising strategy but requires further study to document its efficacy.
Keywords: adverse drug event, medical error, patient participation
Address reprint requests to Saul N. Weingart, Center for Patient Safety, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA. E-mail: saul_weingart{at}dfci.harvard.edu
Accepted for publication August 13, 2004.
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