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Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies
OBJECTIVE: Opioids are increasingly prescribed and frequently involved in adverse drug events (ADEs). The underlying nature of opioid-related ADEs (ORADEs) is however understudied. This hampers our understanding of risks related to opioid use during hospitalisation and when designing interventions....
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7528356/ https://www.ncbi.nlm.nih.gov/pubmed/32998923 http://dx.doi.org/10.1136/bmjopen-2020-038037 |
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author | Schutijser, Bernadette Clara Francisca Maria Jongerden, Irene Klopotowska, Joanna Ewa Moesker, Marco Langelaan, Maaike Wagner, Cordula de Bruijne, Martine |
author_facet | Schutijser, Bernadette Clara Francisca Maria Jongerden, Irene Klopotowska, Joanna Ewa Moesker, Marco Langelaan, Maaike Wagner, Cordula de Bruijne, Martine |
author_sort | Schutijser, Bernadette Clara Francisca Maria |
collection | PubMed |
description | OBJECTIVE: Opioids are increasingly prescribed and frequently involved in adverse drug events (ADEs). The underlying nature of opioid-related ADEs (ORADEs) is however understudied. This hampers our understanding of risks related to opioid use during hospitalisation and when designing interventions. Therefore, we provided a description of the nature of ORADEs. DESIGN: A post-hoc analysis of data collected during three retrospective patient record review studies (in 2008, 2011/2012 and 2015/2016). SETTING: The three record review studies were conducted in 32 Dutch hospitals. PARTICIPANTS: A total of 10 917 patient records were assessed by trained nurses and physicians. OUTCOME MEASURES: Per identified ORADE, we described preventability, type of medication error, attributable factors and type of opioids involved. Moreover, the characteristics of preventable and non-preventable ORADEs were compared to identify risk factors. RESULTS: Out of 10 917 patient records, 357 ADEs were identified, of which 28 (8%) involved opioids. Eleven ORADEs were assessed as preventable. Of these, 10 were caused by dosing errors and 4 probably contributed to patients’ death. Attributable factors identified were mainly on patient and organisational levels. Morphine and oxycodone were the most frequently involved opioids. The risk for ORADEs was higher in elderly patients. CONCLUSIONS: Only 8% of ADEs identified in our sample were related to opioids. Although the frequency is low, the risk of serious consequences is high. We recommend to use our findings to increase awareness among physicians and nurses. Future interventions should focus on safe dosing of opioids when prescribing and administering, especially in elderly patients. |
format | Online Article Text |
id | pubmed-7528356 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-75283562020-10-19 Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies Schutijser, Bernadette Clara Francisca Maria Jongerden, Irene Klopotowska, Joanna Ewa Moesker, Marco Langelaan, Maaike Wagner, Cordula de Bruijne, Martine BMJ Open Pharmacology and Therapeutics OBJECTIVE: Opioids are increasingly prescribed and frequently involved in adverse drug events (ADEs). The underlying nature of opioid-related ADEs (ORADEs) is however understudied. This hampers our understanding of risks related to opioid use during hospitalisation and when designing interventions. Therefore, we provided a description of the nature of ORADEs. DESIGN: A post-hoc analysis of data collected during three retrospective patient record review studies (in 2008, 2011/2012 and 2015/2016). SETTING: The three record review studies were conducted in 32 Dutch hospitals. PARTICIPANTS: A total of 10 917 patient records were assessed by trained nurses and physicians. OUTCOME MEASURES: Per identified ORADE, we described preventability, type of medication error, attributable factors and type of opioids involved. Moreover, the characteristics of preventable and non-preventable ORADEs were compared to identify risk factors. RESULTS: Out of 10 917 patient records, 357 ADEs were identified, of which 28 (8%) involved opioids. Eleven ORADEs were assessed as preventable. Of these, 10 were caused by dosing errors and 4 probably contributed to patients’ death. Attributable factors identified were mainly on patient and organisational levels. Morphine and oxycodone were the most frequently involved opioids. The risk for ORADEs was higher in elderly patients. CONCLUSIONS: Only 8% of ADEs identified in our sample were related to opioids. Although the frequency is low, the risk of serious consequences is high. We recommend to use our findings to increase awareness among physicians and nurses. Future interventions should focus on safe dosing of opioids when prescribing and administering, especially in elderly patients. BMJ Publishing Group 2020-09-30 /pmc/articles/PMC7528356/ /pubmed/32998923 http://dx.doi.org/10.1136/bmjopen-2020-038037 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Pharmacology and Therapeutics Schutijser, Bernadette Clara Francisca Maria Jongerden, Irene Klopotowska, Joanna Ewa Moesker, Marco Langelaan, Maaike Wagner, Cordula de Bruijne, Martine Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
title | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
title_full | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
title_fullStr | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
title_full_unstemmed | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
title_short | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
title_sort | nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
topic | Pharmacology and Therapeutics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7528356/ https://www.ncbi.nlm.nih.gov/pubmed/32998923 http://dx.doi.org/10.1136/bmjopen-2020-038037 |
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