Blog | Monday, May 21, 2012

QD: News Every Day--Over half of drug-related morbidities deemed preventable

Two studies from Norway drug-related morbidity may affect more than half of all patients, much more than observational studies suggest might occur.

Physicians estimated that 51% of all patients outside hospitals and 54% of all hospitalized patients experience drug-related morbidity, while pharmacists estimated this to affect 61% of all patients in health care, researchers reported in two studies.

Of the affected patients, 24 to 45% were estimated to experience preventable drug-related morbidity, and the resulting costs were 730 euros to 1,645 euros per patient with drug-related morbidity.

Drug-related morbidity is defined as new medical problems, such as adverse drug reactions, drug dependence and intoxication, and as therapeutic failures, such as insufficient effects of medicine and morbidity due to untreated indications.

The two expert panels of physicians and pharmacists estimated the proportion of patients experiencing drug-related morbidity, the proportion they perceived as preventable, and the clinical consequences resulting from drug-related morbidity. Costs to the health care system were modeled based on national statistics for costs of health care consumption.

Researchers at the Nordic School of Public Health NHV noted that this method was used to estimate the costs of drug-related morbidity in the U.S.

In the first study, which appeared in the International Journal of Clinical Pharmacy, an expert panel of pharmacists determined the probabilities of therapeutic outcomes of medication therapy. The cost-of-illness analysis included direct costs from the health care perspective.

The expert panel estimated that 61% +/- 14% (mean +/- SD) of all patients attending health care suffered from drug-related morbidity, of which 29% +/- 8% suffered from new medical problems, 18% +/- 6% from therapeutic failures, and 15% +/- 7% from a combination of both.

Drug-related morbidity was considered preventable in 45% +/- 15% of the patients with drug-related morbidity. The estimated cost-of-illness was 997 euros per patient attending health care, corresponding to an annual cost of 6.6 billion euros to the Swedish health care system.

In the second study, which appeared in the European Journal of Clinical Pharmacology, a panel of 19 physicians estimated the probabilities of drug-related morbidity, preventable drug-related morbidity, and clinical outcomes of drug-related morbidity separately for outpatients and inpatients.

Physicians estimated that 51% +/- 22% of outpatients experience drug-related morbidity and 12% +/- 8% preventable drug-related morbidity. Of inpatients, 54% +/- 17% was estimated to experience drug-related morbidity and 16% +/- 7% preventable drug-related morbidity. Of outpatients with drug-related morbidity, 24% +/- 11% was estimated to experience preventable drug-related morbidity, whereas this proportion for inpatients was 31% +/- 15%. The estimated cost-of-illness was 376 euros per outpatient and 838 euros per inpatient.