Incidence of adverse drug events in public and private hospitals in Riyadh, Saudi Arabia: the (ADESA) prospective cohort study

Hisham Aljadhey, Mansour A. Mahmoud, Yusuf Ahmed, Razia Sultana, Salah Zouein, Sulafah Alshanawani, Ahmed Mayet, Mashael K. Alshaikh, Nora Kalagi, Esraa Al Tawil, Abdul Rahman El Kinge, Abdulmajid Arwadi, Maha Alyahya, Michael Murray, David Bates

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVES: To determine the incidence of adverse drug events (ADEs) and assess their severity and preventability in four Saudi hospitals.

DESIGN: Prospective cohort study.

SETTING: The study included patients admitted to medical, surgical and intensive care units (ICUs) of four hospitals in Saudi Arabia. These hospitals include a 900-bed tertiary teaching hospital, a 400-bed private hospital, a 1400-bed large government hospital and a 350-bed small government hospital.

PARTICIPANTS: All patients (≥12 years) admitted to the study units over 4 months.

PRIMARY AND SECONDARY OUTCOME MEASURES: Incidents were collected by pharmacists and reviewed by independent clinicians. Reviewers classified the identified incidents as ADEs, potential ADEs (PADEs) or medication errors and then determined their severity and preventability.

RESULTS: We followed 4041 patients from admission to discharge. Of these, 3985 patients had complete data for analysis. The mean±SD age of patients in the analysed cohort was 43.4±19.0 years. A total of 1676 ADEs were identified by pharmacists during the medical chart review. Clinician reviewers accepted 1531 (91.4%) of the incidents identified by the pharmacists (245 ADEs, 677 PADEs and 609 medication errors with low risk of causing harm). The incidence of ADEs was 6.1 (95% CI 5.4 to 6.9) per 100 admissions and 7.9 (95% CI 6.9 to 8.9) per 1000 patient-days. The occurrence of ADEs was most common in ICUs (149 (60.8%)) followed by medical (67 (27.3%)) and surgical (29 (11.8%)) units. In terms of severity, 129 (52.7%) of the ADEs were significant, 91 (37.1%) were serious, 22 (9%) were life-threatening and three (1.2%) were fatal.

CONCLUSIONS: We found that ADEs were common in Saudi hospitals, especially in ICUs, causing significant morbidity and mortality. Future studies should focus on investigating the root causes of ADEs at the prescribing stage, and development and testing of interventions to minimise harm from medications.

Original languageEnglish (US)
Pages (from-to)e010831
JournalBMJ Open
Volume6
Issue number7
DOIs
StatePublished - Jul 12 2016
Externally publishedYes

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Private Hospitals
Saudi Arabia
Public Hospitals
Drug-Related Side Effects and Adverse Reactions
Cohort Studies
Prospective Studies
Incidence
Pharmacists
Intensive Care Units
Medication Errors
Patient Admission
Critical Care
Tertiary Care Centers
Teaching Hospitals
Outcome Assessment (Health Care)
Morbidity

Keywords

  • Adverse Drug Events (ADEs)
  • prospective cohort study
  • Saudi Arabia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Aljadhey, H., Mahmoud, M. A., Ahmed, Y., Sultana, R., Zouein, S., Alshanawani, S., ... Bates, D. (2016). Incidence of adverse drug events in public and private hospitals in Riyadh, Saudi Arabia: the (ADESA) prospective cohort study. BMJ Open, 6(7), e010831. https://doi.org/10.1136/bmjopen-2015-010831

Incidence of adverse drug events in public and private hospitals in Riyadh, Saudi Arabia : the (ADESA) prospective cohort study. / Aljadhey, Hisham; Mahmoud, Mansour A.; Ahmed, Yusuf; Sultana, Razia; Zouein, Salah; Alshanawani, Sulafah; Mayet, Ahmed; Alshaikh, Mashael K.; Kalagi, Nora; Al Tawil, Esraa; El Kinge, Abdul Rahman; Arwadi, Abdulmajid; Alyahya, Maha; Murray, Michael; Bates, David.

In: BMJ Open, Vol. 6, No. 7, 12.07.2016, p. e010831.

Research output: Contribution to journalArticle

Aljadhey, H, Mahmoud, MA, Ahmed, Y, Sultana, R, Zouein, S, Alshanawani, S, Mayet, A, Alshaikh, MK, Kalagi, N, Al Tawil, E, El Kinge, AR, Arwadi, A, Alyahya, M, Murray, M & Bates, D 2016, 'Incidence of adverse drug events in public and private hospitals in Riyadh, Saudi Arabia: the (ADESA) prospective cohort study', BMJ Open, vol. 6, no. 7, pp. e010831. https://doi.org/10.1136/bmjopen-2015-010831
Aljadhey, Hisham ; Mahmoud, Mansour A. ; Ahmed, Yusuf ; Sultana, Razia ; Zouein, Salah ; Alshanawani, Sulafah ; Mayet, Ahmed ; Alshaikh, Mashael K. ; Kalagi, Nora ; Al Tawil, Esraa ; El Kinge, Abdul Rahman ; Arwadi, Abdulmajid ; Alyahya, Maha ; Murray, Michael ; Bates, David. / Incidence of adverse drug events in public and private hospitals in Riyadh, Saudi Arabia : the (ADESA) prospective cohort study. In: BMJ Open. 2016 ; Vol. 6, No. 7. pp. e010831.
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AU - Aljadhey, Hisham

AU - Mahmoud, Mansour A.

AU - Ahmed, Yusuf

AU - Sultana, Razia

AU - Zouein, Salah

AU - Alshanawani, Sulafah

AU - Mayet, Ahmed

AU - Alshaikh, Mashael K.

AU - Kalagi, Nora

AU - Al Tawil, Esraa

AU - El Kinge, Abdul Rahman

AU - Arwadi, Abdulmajid

AU - Alyahya, Maha

AU - Murray, Michael

AU - Bates, David

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N2 - OBJECTIVES: To determine the incidence of adverse drug events (ADEs) and assess their severity and preventability in four Saudi hospitals.DESIGN: Prospective cohort study.SETTING: The study included patients admitted to medical, surgical and intensive care units (ICUs) of four hospitals in Saudi Arabia. These hospitals include a 900-bed tertiary teaching hospital, a 400-bed private hospital, a 1400-bed large government hospital and a 350-bed small government hospital.PARTICIPANTS: All patients (≥12 years) admitted to the study units over 4 months.PRIMARY AND SECONDARY OUTCOME MEASURES: Incidents were collected by pharmacists and reviewed by independent clinicians. Reviewers classified the identified incidents as ADEs, potential ADEs (PADEs) or medication errors and then determined their severity and preventability.RESULTS: We followed 4041 patients from admission to discharge. Of these, 3985 patients had complete data for analysis. The mean±SD age of patients in the analysed cohort was 43.4±19.0 years. A total of 1676 ADEs were identified by pharmacists during the medical chart review. Clinician reviewers accepted 1531 (91.4%) of the incidents identified by the pharmacists (245 ADEs, 677 PADEs and 609 medication errors with low risk of causing harm). The incidence of ADEs was 6.1 (95% CI 5.4 to 6.9) per 100 admissions and 7.9 (95% CI 6.9 to 8.9) per 1000 patient-days. The occurrence of ADEs was most common in ICUs (149 (60.8%)) followed by medical (67 (27.3%)) and surgical (29 (11.8%)) units. In terms of severity, 129 (52.7%) of the ADEs were significant, 91 (37.1%) were serious, 22 (9%) were life-threatening and three (1.2%) were fatal.CONCLUSIONS: We found that ADEs were common in Saudi hospitals, especially in ICUs, causing significant morbidity and mortality. Future studies should focus on investigating the root causes of ADEs at the prescribing stage, and development and testing of interventions to minimise harm from medications.

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