An analysis of anticoagulant adverse drug events in a large community teaching hospital

Excerpt

Annually, over 770,000 people are injured or die in hospitals from adverse drug events (ADEs). Patients who experience an ADE are hospitalized an average of 8–12 days longer than patients who do not suffer an ADE. Treatment with anticoagulants can lead to ADEs. Advocate Christ Medical Center’s (ACMC) Pharmacy Department reviewed its anticoagulant ADEs. A retrospective analysis was conducted to identify all ADEs associated with anticoagulants for a twelve month period. All hospitalized patients were identified using the ADE code from the patient’s chart. Each chart was analyzed for the following: type of anticoagulant, severity of ADE, INR value, treatment offered, adherence to American College of Chest Physicians (ACCP) Guidelines for Vitamin K1 administration, and was anticoagulant the reason for hospital admission. There were 1,765 ADEs reported for the year of 2005. Anticoagulants accounted for 227 (13.2%) of all ADEs. Patients receiving warfarin with a supratherapeutic INR were further analyzed to determine adherence to ACCP’s guidelines for the use of Vitamin K1. There were 109 patients who received Vitamin K1, of which 102 (94%) received it appropriately. Forty-eight percent of anticoagulant ADEs were identified as the reason for hospital admission. Thirty-seven percent of the admitted patients required a prolonged stay due to the severity of the ADE. Seventy-six percent of the anticoagulant ADEs were due to warfarin and only 10.6% was due to heparin. Anticoagulants are high-alert medications that are indicated for many disease states. Hospitals need to annually analyze and identify areas for improvement. Interventions to reduce anticoagulant ADEs need to be implemented. The data reveals that there is a high volume of patients that present to the hospital or have a prolonged length of stay secondary to an anticoagulant ADE. Pharmacist intervention in the Anticoagulation Clinic should decrease the number of ADEs therefore decreasing length of stay as well as overall health costs. …