Groups such as Kyoto Prefectural Medical University conducted clinical epidemiological surveys at long-term care facilities in Japan (hereinafter referred to as long-term care facilities), and conducted adverse drug events (Adverse Drug Events) for residents of long-term care facilities. Below, we report the frequency of occurrence of ADE) and drug-related errors (Medication Error: unexpected deviations associated with drug use. Below, ME).
This study was conducted as part of the JADE-Study (Japan Pharmaceutical Adverse Event Study), and in one year from August 2016, it will be in 8 nursing homes (1 nursing homes for the elderly and 4 special nursing homes for the elderly). 2 people who entered other than the short stay participated.As a result of the survey, ADE occurred in 2 cases in 459 people, which is 73% of all subjects, and ME occurred in 336 cases in 1207 people, which is 39%. There were about 177 cases and 600 cases per person per month when entering the month, respectively.In addition, one-third of all ADEs are accompanied by ME, and it is said that they were preventable ADEs.
Furthermore, regarding the stage where ME occurred, the observation stage after drug administration accounted for about 7%, and although there was no statistically significant difference, ADE due to drug dose reduction or discontinuation was compared with other ADEs. There was a tendency for the proportion of fatal or life-threatening ones to be high.This usually means that after entering the facility, one contract doctor will prescribe the drug instead of multiple specialists, so it will be necessary to adjust multiple drugs at the same time, resulting in ADE and ME in the process. Suggest that it may be.
While many long-term care facility residents take multiple drugs for the treatment of chronic diseases, this study clarified that the occurrence of ADE / ME is common in long-term care facilities in Japan.In order to improve the safety of drug use in long-term care facilities, it is important to appropriately adjust multiple drugs and evaluate the effects of medication content before and after admission with the intervention of general practitioners and pharmacists. Be done.
Paper information:[BMJ Quality & Safety] Epidemiology of adverse drug events and medication errors in four nursing homes in Japan: the Japan Adverse Drug Events (JADE) Study
