Application of the Pareto principle to identify and address drug-therapy safety issues

Müller F, Dormann H, Pfistermeister B, Sonst A, Patapovas A, Vogler R, Hartmann N, Plank-Kiegele B, Kirchner M, Bürkle T, Maas R (2014)

Publication Type: Journal article

Publication year: 2014

Journal

European Journal of Clinical Pharmacology Springer Verlag (Germany)

Book Volume: 70

Pages Range: 727-36

Journal Issue: 6

DOI: 10.1007/s00228-014-1665-2

Abstract

Adverse drug events (ADE) and medication errors (ME) are common causes of morbidity in patients presenting at emergency departments (ED). Recognition of ADE as being drug related and prevention of ME are key to enhancing pharmacotherapy safety in ED. We assessed the applicability of the Pareto principle (~80 % of effects result from 20 % of causes) to address locally relevant problems of drug therapy.In 752 cases consecutively admitted to the nontraumatic ED of a major regional hospital, ADE, ME, contributing drugs, preventability, and detection rates of ADE by ED staff were investigated. Symptoms, errors, and drugs were sorted by frequency in order to apply the Pareto principle.In total, 242 ADE were observed, and 148 (61.2 %) were assessed as preventable. ADE contributed to 110 inpatient hospitalizations. The ten most frequent symptoms were causally involved in 88 (80.0 %) inpatient hospitalizations. Only 45 (18.6 %) ADE were recognized as drug-related problems until discharge from the ED. A limited set of 33 drugs accounted for 184 (76.0 %) ADE; ME contributed to 57 ADE. Frequency-based listing of ADE, ME, and drugs involved allowed identification of the most relevant problems and development of easily to implement safety measures, such as wall and pocket charts.The Pareto principle provides a method for identifying the locally most relevant ADE, ME, and involved drugs. This permits subsequent development of interventions to increase patient safety in the ED admission process that best suit local needs.

Authors with CRIS profile

Fabian Müller Lehrstuhl für Klinische Pharmakologie und Klinische Toxikologie Barbara Pfistermeister Lehrstuhl für Klinische Pharmakologie und Klinische Toxikologie Andrius Patapovas Lehrstuhl für Medizinische Informatik Nina Hartmann Professur für Arzneimitteltherapiesicherheit und Klinische Pharmakologie Bettina Plank-Kiegele Institut für Experimentelle und Klinische Pharmakologie und Toxikologie Melanie Kirchner Lehrstuhl für Medizinische Informatik Thomas Bürkle Lehrstuhl für Medizinische Informatik Renke Maas Professur für Arzneimitteltherapiesicherheit und Klinische Pharmakologie

Involved external institutions

Klinikum Fürth DE Germany (DE)

How to cite

APA:

Müller, F., Dormann, H., Pfistermeister, B., Sonst, A., Patapovas, A., Vogler, R.,... Maas, R. (2014). Application of the Pareto principle to identify and address drug-therapy safety issues. European Journal of Clinical Pharmacology, 70(6), 727-36. https://doi.org/10.1007/s00228-014-1665-2

MLA:

Müller, Fabian, et al. "Application of the Pareto principle to identify and address drug-therapy safety issues." European Journal of Clinical Pharmacology 70.6 (2014): 727-36.

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