Prevalence and Perceived Preventability of Self-Reported Adverse Drug Events – A Population-Based Survey of 7099 Adults

Daniel Morgan,Katja Marja Hakkarainen,Staffan Hägg,Max Petzold,Karolina Andersson Sundell

doi:10.1371/journal.pone.0073166

Daniel Morgan, Katja Marja Hakkarainen + Show 3 more

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https://doi.org/10.1371/journal.pone.0073166

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Abstract

PurposeAdverse drug events (ADEs) are common and often preventable among inpatients, but self-reported ADEs have not been investigated in a representative sample of the general public. The objectives of this study were to estimate the 1-month prevalence of self-reported ADEs among the adult general public, and the perceived preventability of 2 ADE categories: adverse drug reactions (ADRs) and sub-therapeutic effects (STEs).MethodsIn this cross-sectional study, a postal survey was sent in October 2010 to a random sample of 13 931 Swedish residents aged ≥18 years. Self-reported ADEs experienced during the past month included ADRs, STEs, drug dependence, drug intoxications and morbidity due to drug-related untreated indication. ADEs could be associated with prescription, non-prescription or herbal drugs. The respondents estimated whether ADRs and STEs could have been prevented. ADE prevalences in age groups (18–44, 45–64, or ≥65 years) were compared.ResultsOf 7099 respondents (response rate 51.0%), ADEs were reported by 19.4% (95% confidence interval, 18.5–20.3%), and the prevalence did not differ by age group (p>0.05). The prevalences of self-reported ADRs, STEs, and morbidities due to drug-related untreated indications were 7.8% (7.2–8.4%), 7.6% (7.0–8.2%) and 8.1% (7.5–8.7%), respectively. The prevalence of self-reported drug dependence was 2.2% (1.9–2.6%), and drug intoxications 0.2% (0.1–0.3%). The respondents considered 19.2% (14.8–23.6%) of ADRs and STEs preventable. Although reported drugs varied between ADE categories, most ADEs were attributable to commonly dispensed drugs. Drugs reported for all and preventable events were similar.ConclusionsOne-fifth of the adult general public across age groups reported ADEs during the past month, indicating a need for prevention strategies beyond hospitalised patients. For this, the underlying causes of ADEs should increasingly be investigated. The high burden of ADEs and preventable ADEs from widely used drugs across care settings supports redesigning a safer healthcare system to adequately tackle the problem.

Highlights

Improving patient safety and reducing preventable patient harm, including adverse drug events (ADEs), is emphasised by national and global health authorities [1,2]
Definitions An ADE was defined as ‘‘an injury resulting from medical intervention related to a drug’’ [3], and ADEs could be associated with prescription, non-prescription or herbal drugs
The prevalence did not differ in the three age groups for all ADEs, adverse drug reactions (ADRs), drug intoxications, and morbidities due to drugrelated untreated indications

Summary

Introduction

Improving patient safety and reducing preventable patient harm, including adverse drug events (ADEs), is emphasised by national and global health authorities [1,2]. Few studies have defined sub-categories of ADEs, other than adverse drug reactions (ADRs), even though other types of ADEs have been identified [23,24,25,26,27,28,29,30,31]. We conducted a population-based survey study to estimate the 1month prevalence of self-reported ADEs, sub-categories of ADEs, and two sub-categories of preventable ADEs (ADRs and subtherapeutic effects of drug therapy (STEs)) among the adult general public in Sweden. Other aims were to assess the perceived preventability of ADRs and STEs by the general public, and to identify drug classes and organ systems associated with selfreported ADEs

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