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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....

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Autores principales: Schutijser, Bernadette Clara Francisca Maria, Jongerden, Irene, Klopotowska, Joanna Ewa, Moesker, Marco, Langelaan, Maaike, Wagner, Cordula, de Bruijne, Martine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
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.
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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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