Sharing Adverse Drug Event Reports Between Hospitals and Community Pharmacists to Inform Re-dispensing: An Analysis of Reports and Process Outcomes

Amber Cragg, Serena S. Small, Erica Lau, Adrianna Rowe, Anthony Lau, Katherine Butcher and Corinne M. Hohl ()
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Amber Cragg: University of British Columbia
Serena S. Small: University of British Columbia
Erica Lau: University of British Columbia
Adrianna Rowe: University Health Network
Anthony Lau: Vancouver General Hospital
Katherine Butcher: Vancouver General Hospital
Corinne M. Hohl: University of British Columbia

Drug Safety, 2023, vol. 46, issue 11, No 8, 1172 pages

Abstract: Abstract Introduction Adverse drug events (ADEs) are a leading cause of unplanned hospital visits. We designed ActionADE, an online ADE reporting platform, and integrated it with PharmaNet, British Columbia’s (BC's) provincial medication dispensing system, to overcome identified barriers in ADE reporting and communicate ADEs to community pharmacies. Our objectives were to characterise ADEs reported in ActionADE, explore associations between patients’ age, sex and ADE characteristics, and estimate the re-dispensation rate of culprit medications in community pharmacies. Methods We conducted a prospective observational study of ADE reporting in four BC hospitals between April 1, 2020 and October 31, 2022. We described the characteristics of ADEs reported into ActionADE, used logistic regression modelling to examine associations between age and sex and ADE characteristics, and calculated rates of avoided culprit drug re-dispensations using community pharmacists’ responses to ActionADE alerts. Results In total, 3591 ADE reports were initiated by hospital clinicians, 3174 of which were included in this analysis. Serious or life-threatening ADEs resulting in permanent disability, hospitalisation, extended hospitalisation, and/or death accounted for 56.7% (1800/3174; 95% CI 55.0%–58.4%) of reports. Males were more likely to have non-adherence reported compared to females and experienced life threatening ADEs at a younger age than females. Of 591 patients who had ≥ 1 adverse drug reaction or allergy report (a subset of ADEs) transmitted to community pharmacies, 200 subsequently attempted to re-fill the culprit or a same class drug. Community pharmacists responded to preventative alerts by avoiding re-dispensation in 33.0% (66/200; 95% CI 26.5–39.5%). Interpretation ActionADE is the first interoperable system that communicates ADEs via a central medication database to community pharmacies. Every 10th ADE reported in ActionADE and shared to PharmaNet resulted in community pharmacists’ avoiding one culprit or same class drug re-exposure. Further research is needed to understand ActionADE’s impact on patient and health system outcomes.

Date: 2023
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DOI: 10.1007/s40264-023-01348-7

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