Up to 1.9 Million Adverse effects-180,000 FATAL

Though the safety of prescription drugs has been recognized as important for some time, numerous studies have brought the topic back into the public eye as a major public health issue.

Studies conducted in the 1960s reported that 30 percent of medical patients experienced at least one adverse reaction to drugs during their hospital stay, and three percent of hospitalizations were a direct result of such reactions. During this time, adverse effects of drugs were viewed as an inevitable part of medical care.

Current studies of adverse drug events (ADEs) reveal that ADEs occur in 6.5 percent to more than 20 percent of hospitalized patients, and, unlike in the past, it is now believed that many ADEs are avoidable.

According to one study of Medicare patients, the classes of drugs most frequently associated with ADEs were cardiovascular agents, antibiotics, diuretics, nonopioid analgesics and anticoagulants.

It has been estimated that as many as 1.9 million ADEs occur each year, and up to 180,000 of them could be life threatening or fatal.

In terms of preventability, studies have found a wide range of data indicating that from 13 percent to 70 percent of ADEs may be preventable. Assessing preventability is challenging because studies use different definitions and criteria. For instance, one study considered rashes and diarrhea from antibiotic use not preventable, but if overuse of antibiotics were addressed, these reactions could likely be prevented.

Addressing issues such as errors in prescribing medications, inappropriate, or lack of, monitoring of drug therapies, lack of patient adherence, medication overuse, and underuse of beneficial drug therapies could improve the overall safety of drug use.

Researchers note that medications pose a significant risk to patients and intervention strategies should be implemented to reduce the number of ADEs.

JAMA March 5, 2003;289(9):1154-6

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