Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies
Objective Opioids are increasingly prescribed and frequently involved in adverse drug events (ADEs). The underlying nature of opioid-related ADEs (ORADEs) is however understudied. This hampers our understanding of risks related to opioid use during hospitalisation and when designing interventions. T...
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| Format: | Article |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e038037.full |
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| author | Martine de Bruijne Cordula Wagner Maaike Langelaan Joanna Ewa Klopotowska Irene Jongerden Bernadette Clara Francisca Maria Schutijser Marco Moesker |
| author_facet | Martine de Bruijne Cordula Wagner Maaike Langelaan Joanna Ewa Klopotowska Irene Jongerden Bernadette Clara Francisca Maria Schutijser Marco Moesker |
| author_sort | Martine de Bruijne |
| collection | DOAJ |
| description | Objective Opioids are increasingly prescribed and frequently involved in adverse drug events (ADEs). The underlying nature of opioid-related ADEs (ORADEs) is however understudied. This hampers our understanding of risks related to opioid use during hospitalisation and when designing interventions. Therefore, we provided a description of the nature of ORADEs.Design A post-hoc analysis of data collected during three retrospective patient record review studies (in 2008, 2011/2012 and 2015/2016).Setting The three record review studies were conducted in 32 Dutch hospitals.Participants A total of 10 917 patient records were assessed by trained nurses and physicians.Outcome measures Per identified ORADE, we described preventability, type of medication error, attributable factors and type of opioids involved. Moreover, the characteristics of preventable and non-preventable ORADEs were compared to identify risk factors.Results Out of 10 917 patient records, 357 ADEs were identified, of which 28 (8%) involved opioids. Eleven ORADEs were assessed as preventable. Of these, 10 were caused by dosing errors and 4 probably contributed to patients’ death. Attributable factors identified were mainly on patient and organisational levels. Morphine and oxycodone were the most frequently involved opioids. The risk for ORADEs was higher in elderly patients.Conclusions Only 8% of ADEs identified in our sample were related to opioids. Although the frequency is low, the risk of serious consequences is high. We recommend to use our findings to increase awareness among physicians and nurses. Future interventions should focus on safe dosing of opioids when prescribing and administering, especially in elderly patients. |
| format | Article |
| id | doaj-art-1c228d36460642e3acc9b8dbce115c0e |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-1c228d36460642e3acc9b8dbce115c0e2025-01-08T05:35:09ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-038037Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studiesMartine de Bruijne0Cordula Wagner1Maaike Langelaan2Joanna Ewa Klopotowska3Irene Jongerden4Bernadette Clara Francisca Maria Schutijser5Marco Moesker6Public and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsNIVEL, Netherlands Institute for Health Services Research, Utrecht, The NetherlandsNIVEL, Utrecht, The NetherlandsMedical Informatics, Amsterdam UMC Locatie AMC, Amsterdam, The NetherlandsPublic and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsPublic and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsPublic and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsObjective Opioids are increasingly prescribed and frequently involved in adverse drug events (ADEs). The underlying nature of opioid-related ADEs (ORADEs) is however understudied. This hampers our understanding of risks related to opioid use during hospitalisation and when designing interventions. Therefore, we provided a description of the nature of ORADEs.Design A post-hoc analysis of data collected during three retrospective patient record review studies (in 2008, 2011/2012 and 2015/2016).Setting The three record review studies were conducted in 32 Dutch hospitals.Participants A total of 10 917 patient records were assessed by trained nurses and physicians.Outcome measures Per identified ORADE, we described preventability, type of medication error, attributable factors and type of opioids involved. Moreover, the characteristics of preventable and non-preventable ORADEs were compared to identify risk factors.Results Out of 10 917 patient records, 357 ADEs were identified, of which 28 (8%) involved opioids. Eleven ORADEs were assessed as preventable. Of these, 10 were caused by dosing errors and 4 probably contributed to patients’ death. Attributable factors identified were mainly on patient and organisational levels. Morphine and oxycodone were the most frequently involved opioids. The risk for ORADEs was higher in elderly patients.Conclusions Only 8% of ADEs identified in our sample were related to opioids. Although the frequency is low, the risk of serious consequences is high. We recommend to use our findings to increase awareness among physicians and nurses. Future interventions should focus on safe dosing of opioids when prescribing and administering, especially in elderly patients.https://bmjopen.bmj.com/content/10/9/e038037.full |
| spellingShingle | Martine de Bruijne Cordula Wagner Maaike Langelaan Joanna Ewa Klopotowska Irene Jongerden Bernadette Clara Francisca Maria Schutijser Marco Moesker Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies BMJ Open |
| title | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
| title_full | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
| title_fullStr | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
| title_full_unstemmed | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
| title_short | Nature of adverse events with opioids in hospitalised patients: a post-hoc analysis of three patient record review studies |
| title_sort | nature of adverse events with opioids in hospitalised patients a post hoc analysis of three patient record review studies |
| url | https://bmjopen.bmj.com/content/10/9/e038037.full |
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