In a 5-month study of 973 patients with cancer, 12% of 1,299 hospital admissions were due to drug-related problems. And of those, over half were deemed preventable, say researchers from the National Cancer Centre Singapore.
The study was conducted at the 2 main oncology wards at the largest acute tertiary hospital in Singapore. Patients were screened for any drug-related problems (DRPs) that led to the hospital admission. After screening, patients were classified as DRP, non-DRP (such as cancer progression or other diseases), unclear (lacking sufficient information for definitive classification), and exclusion (eg, patients receiving trial drugs, aged < 21 years, or not diagnosed with cancer). DRP cases were classified as minor, moderate, or severe and not preventable, probably preventable, or definitely preventable.
The most common reasons for drug-related admission were myelosuppression and suspected infection (90 patients; 59.6%). Nearly all DRPs were adverse reactions, and nearly all were moderately severe.
More important, perhaps, was the fact that 51 DRPs were classified as “probably preventable” (37.2%) and 21 as “definitely preventable” (15.3%). The researchers note that, due to the complexity of cancer treatment, DRPs—particularly adverse reactions—can happen even when preventive measures are used. Moreover, they say, when an event was classified as definitely or probably preventable, “it remains uncertain whether the event could have actually been prevented even if care had been optimal.”
Length of stay was found to be correlated with direct medical costs (P < .001) and was longer for preventable drug-related admissions than for nonpreventable drug-related admissions (P = .02). The treatment cost of admissions for preventable DRPs, the researchers found, constituted almost half the total direct medical costs.
Source
Ko Y, Gwee Y-S, Huang Y-C, Chiang J, Chan A. Clin Ther. 2014;36(4):588-592.
doi: 10.1016/j.clinthera.2014.02.014.
