Identification and Characterization of Preventable Adverse Drug Events in Family Medicine Clinics from Central Saudi Arabia

Ghadah A Assiri; Abdulelah S Bin Shihah; Mohammed K Alkhalifah; Ali S Alshehri; Abdullah H Alkhenizan

doi:10.4103/sjmms.sjmms_124_22

Identification and Characterization of Preventable Adverse Drug Events in Family Medicine Clinics from Central Saudi Arabia

Saudi J Med Med Sci. 2023 Jan-Mar;11(1):26-35. doi: 10.4103/sjmms.sjmms_124_22. Epub 2023 Jan 9.

Authors

Ghadah A Assiri¹, Abdulelah S Bin Shihah², Mohammed K Alkhalifah², Ali S Alshehri³, Abdullah H Alkhenizan²

Affiliations

¹ Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
² Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
³ Executive Department of Organization Development, First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia.

Abstract

Background: Medication errors can result in adverse drug events (ADEs) and cause considerable patient harm. Limited data are available from Saudi Arabia and the Middle East regarding the prevalence of preventable adverse drug events (pADEs) in primary care settings.

Objectives: To estimate the period prevalence of pADEs and assess the medication error severity in primary care setting in Saudi Arabia.

Methods: This retrospective study is a continuation of a previous study where 117 of 2000 adult patients managed at the Family Medicine clinics of King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, were identified to have had least one medication error in the past 15 months. The electronic health records of these 117 patients were analyzed for a 3-month post-medication error period to explore the presence of pADE. Medication errors were categorized according to the National Coordinating Council for Medication Error Reporting and Prevention index (NCC MERP) and the occurrence of pADE was assessed using the NCC MERP scheme.

Results: Of the included 117 patients, 9 (7.7% [95% confidence interval (CI): 2.79-12.59]) experienced pADE (Category E), while 108 (92.3% [95% CI: 87.97-98.35]) did not (Category C). All patients who experienced pADE were using over-the-counter medications and were on polypharmacy. Outcomes 2a and 2b (asthma and β-blocker) accounted for two and four cases, respectively, while Outcomes 6 (warfarin and international normalized ratio), 7 (lithium and lithium level), 16 (new oral anti-coagulant or warfarin and antiplatelet), and 17 (acetylsalicylic acid [aspirin] and antiplatelet) each accounted for one case.

Conclusions: This study provides the period prevalence of patients with pADEs from Family Medicine clinics at a major tertiary hospital of Saudi Arabia, and highlights the need for a multicenter study of clinically important medication errors at the prescribing and monitoring stages for the development of quality improvement programs.

Keywords: Adult; adverse drug event; adverse drug reaction reporting systems; electronic health records; medication errors; preventable; primary health care.