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Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study
BACKGROUND: Adverse drug events are unintended and harmful events related to medications. Adverse drug events are important for patient care, quality improvement, drug safety research, and postmarketing surveillance, but they are vastly underreported. OBJECTIVE: Our objectives were to identify barri...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849794/ https://www.ncbi.nlm.nih.gov/pubmed/29487041 http://dx.doi.org/10.2196/publichealth.9282 |
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author | Hohl, Corinne M Small, Serena S Peddie, David Badke, Katherin Bailey, Chantelle Balka, Ellen |
author_facet | Hohl, Corinne M Small, Serena S Peddie, David Badke, Katherin Bailey, Chantelle Balka, Ellen |
author_sort | Hohl, Corinne M |
collection | PubMed |
description | BACKGROUND: Adverse drug events are unintended and harmful events related to medications. Adverse drug events are important for patient care, quality improvement, drug safety research, and postmarketing surveillance, but they are vastly underreported. OBJECTIVE: Our objectives were to identify barriers to adverse drug event documentation and factors contributing to underreporting. METHODS: This qualitative study was conducted in 1 ambulatory center, and the emergency departments and inpatient wards of 3 acute care hospitals in British Columbia between March 2014 and December 2016. We completed workplace observations and focus groups with general practitioners, hospitalists, emergency physicians, and hospital and community pharmacists. We analyzed field notes by coding and iteratively analyzing our data to identify emerging concepts, generate thematic and event summaries, and create workflow diagrams. Clinicians validated emerging concepts by applying them to cases from their clinical practice. RESULTS: We completed 238 hours of observations during which clinicians investigated 65 suspect adverse drug events. The observed events were often complex and diagnosed over time, requiring the input of multiple providers. Providers documented adverse drug events in charts to support continuity of care but never reported them to external agencies. Providers faced time constraints, and reporting would have required duplication of documentation. CONCLUSIONS: Existing reporting systems are not suited to capture the complex nature of adverse drug events or adapted to workflow and are simply not used by frontline clinicians. Systems that are integrated into electronic medical records, make use of existing data to avoid duplication of documentation, and generate alerts to improve safety may address the shortcomings of existing systems and generate robust adverse drug event data as a by-product of safer care. |
format | Online Article Text |
id | pubmed-5849794 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-58497942018-03-19 Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study Hohl, Corinne M Small, Serena S Peddie, David Badke, Katherin Bailey, Chantelle Balka, Ellen JMIR Public Health Surveill Original Paper BACKGROUND: Adverse drug events are unintended and harmful events related to medications. Adverse drug events are important for patient care, quality improvement, drug safety research, and postmarketing surveillance, but they are vastly underreported. OBJECTIVE: Our objectives were to identify barriers to adverse drug event documentation and factors contributing to underreporting. METHODS: This qualitative study was conducted in 1 ambulatory center, and the emergency departments and inpatient wards of 3 acute care hospitals in British Columbia between March 2014 and December 2016. We completed workplace observations and focus groups with general practitioners, hospitalists, emergency physicians, and hospital and community pharmacists. We analyzed field notes by coding and iteratively analyzing our data to identify emerging concepts, generate thematic and event summaries, and create workflow diagrams. Clinicians validated emerging concepts by applying them to cases from their clinical practice. RESULTS: We completed 238 hours of observations during which clinicians investigated 65 suspect adverse drug events. The observed events were often complex and diagnosed over time, requiring the input of multiple providers. Providers documented adverse drug events in charts to support continuity of care but never reported them to external agencies. Providers faced time constraints, and reporting would have required duplication of documentation. CONCLUSIONS: Existing reporting systems are not suited to capture the complex nature of adverse drug events or adapted to workflow and are simply not used by frontline clinicians. Systems that are integrated into electronic medical records, make use of existing data to avoid duplication of documentation, and generate alerts to improve safety may address the shortcomings of existing systems and generate robust adverse drug event data as a by-product of safer care. JMIR Publications 2018-02-27 /pmc/articles/PMC5849794/ /pubmed/29487041 http://dx.doi.org/10.2196/publichealth.9282 Text en ©Corinne M Hohl, Serena S Small, David Peddie, Katherin Badke, Chantelle Bailey, Ellen Balka. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 27.02.2018. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Hohl, Corinne M Small, Serena S Peddie, David Badke, Katherin Bailey, Chantelle Balka, Ellen Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study |
title | Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study |
title_full | Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study |
title_fullStr | Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study |
title_full_unstemmed | Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study |
title_short | Why Clinicians Don’t Report Adverse Drug Events: Qualitative Study |
title_sort | why clinicians don’t report adverse drug events: qualitative study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849794/ https://www.ncbi.nlm.nih.gov/pubmed/29487041 http://dx.doi.org/10.2196/publichealth.9282 |
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