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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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