Fundamento y objetivo Determinar la incidencia de acontecimientos adversos causados por medicamentos (AAM) en pacientes hospitalizados, diferenciando los potencialmente prevenibles, y describir los medicamentos implicados, las manifestaciones clinicas y los tipos de errores de medicacion asociados a los AAM prevenibles. Pacientes y metodo Estudio observacional de 6 meses de duracion que incluyo a los pacientes hospitalizados en los servicios de Medicina Interna, Neumologia, Gastroenterologia, Nefrologia y Neurologia de un hospital universitario. Los AAM se detectaron prospectivamente mediante comunicacion fomentada y retrospectivamente mediante revision de diagnosticos al alta utilizando codigos CIE-9. Resultados Se detectaron AAM en 191 (7,2%) pacientes de los 2.643 que estuvieron ingresados en ese periodo. De estos casos, 38 (19,9%) se clasificaron como prevenibles; en el 21,1% fueron leves, en el 60,5%, moderados y en el 18,4%, graves o potencialmente mortales. Los medicamentos asociados con mayor frecuencia a los AAM prevenibles fueron antiinfecciosos (22,9%), diureticos (18,8%) y digoxina (16,7%). Los principales tipos de errores que causaron los AAM prevenibles fueron la falta de seguimiento analitico o clinico del tratamiento (28,3%), la prescripcion de dosis elevadas (21,7%), la prescripcion de un medicamento inapropiado (15,0%) o la falta de prescripcion de un medicamento necesario (15,0%) y las interacciones medicamentosas (11,7%). Conclusiones Un 1,4% de los pacientes hospitalizados en unidades medicas presento AAM potencialmente prevenibles. Es preciso concienciar a los profesionales y a las autoridades sanitarias de la trascendencia de este problema e implantar en los hospitales practicas de seguridad efectivas para reducir los errores de medicacion, especialmente los errores de prescripcion y de seguimiento.

/pdf/acontecimientos-adversos-prevenibles-causados-por-3rj1sbhvpl.pdf

Acontecimientos adversos prevenibles causados por medicamentos en pacientes hospitalizados

Objective To estimate the incidence and characteristics of adverse events (AEs) and no-harm events (NHEs) in critically ill patients.

Design Observational, prospective, 24-h cross-sectional study with self-reporting.

Setting Seventy-nine intensive care units at 76 hospitals.

Measurements Number of events, risk of AEs and NHEs, types of incidents, severity and avoidability of incidents.

Results A total of 1017 patients were included in the study; 591 (58%) were affected by one or more incidents. Of the 1424 valid incidents, 943 (66%) were NHEs and 481 (34%) were AEs. The individual risk of suffering at least one incident was 62%, at least one NHE 45% and at least one AE 29%. The median number of incidents, NHEs and AEs was 6, 3 and 2 per 100 patient-hours, respectively. Seventy-four per cent of the incidents were related to medication (24%), equipment (15%), nursing care (14%), accidental withdrawal of vascular accesses and catheters (10%) or airways and mechanical ventilation (10%). AEs resulted in temporary damage in 29% and in permanent damage or damage that compromised patients' lives or contributed to their death in 4%. Incidents were avoidable in 79% of cases (90% in NHEs and 60% in AEs, P < 0.05).

Conclusions The individual risk for incidents in critical patients is high. Many incidents did not harm patients, some caused damage and a few were related to the patient's death. Most incidents were considered avoidable.

Adverse events in Spanish intensive care units: the SYREC study.

The growth of the aging population leads to the increase of chronic diseases, of the burden of multimorbility, and of the complexity polypharmacy. The prevalence of medication errors rises in patients with polypharmacy in primary care, and this is a major concern to healthcare systems. This study reviews the published literature on the inappropriate use of medicines in order to articulate recommendations on how to reduce it in chronic patients, particularly in those who are elderly, polymedicated, or multipathological. A systematic review of articles published from January 2000 to October 2015 was performed using MEDLINE, EMBASE, PsychInfo, Scopus, The Cochrane Library, and Index Medicus databases. We selected 80 studies in order to analyse the content that addressed the question under consideration. Our literature review found that half of patients know what their prescribed treatment is; that most of elderly people take five or more medications a day; that in elderly, polymedicated people, the probability of a medication error occurring is higher; that new tools have been recently developed to reduce errors; that elderly patients can understand written information but the presentation and format is an important factor; and that a high percentage of patients have remaining doubts after their visit. Thus, strategies based on the evidence should be applied in order to reduce medication errors.

https://www.mdpi.com/1660-4601/15/2/310/pdf

Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases.

PURPOSE: There is a lack of homogeneity in the terminology used in the context of patient safety related to medication. The aim of this review was to identify the terms and definitions used in patient safety related to medication within the scientific literature. METHODS: Original and review articles that were indexed between 1998 and 2008 in MEDLINE and EMBASE and contained terms used in patient safety related to medication were included. Terms and definitions were extracted and categorised according to whether its definition referred to the process of medication use, or to the clinical outcome of medication use, or both. RESULTS: Of 2564 articles, 147 were included. Sixty terms used in patient safety related to medication with 189 different definitions were identified. Among terms that referred only to the process of medication use (n = 23), medication error provided the greatest number of definitions (n = 29). Among terms that referred only to the clinical outcome of medication use (n = 31), adverse drug event provided the greatest number of definitions (n = 15). Finally, among terms that referred both to the process of use and to the clinical outcome of medication use (n = 13), drug-related problem provided the greatest number of definitions (n = 7). CONCLUSIONS: A multitude of terms and definitions are used in patient safety related to medication. This heterogeneity makes it difficult to compare the results among studies and to appreciate the true magnitude of the problem. Classifying and unifying the terminology is necessary to advance in patient safety strategies. Copyright © 2012 John Wiley & Sons, Ltd. Language: en

Terms used in patient safety related to medication: a literature review.

La asistencia sanitaria como factor de riesgo: los efectos adversos ligados a la práctica clínica

Errores de medicación: estandarización de la terminología y clasificación Resultados de la Beca Ruiz-Jarabo 2000

https://revistafarmaciahospitalaria.sefh.es/gdcr/index.php/fh/article/download/1022/1022

M. Pérez Encinas

Papers

Errores de medicación: estandarización de la terminología y clasificación Resultados de la Beca Ruiz-Jarabo 2000

Sindrome neuroléptico maligno asociado a antidepresivos tricíclicos