140: Medication Safety and Adverse Drug Events

HISTORY AND EPIDEMIOLOGY

Patient safety is of great interest to many regulatory groups, such as The Joint Commission, hospital administrations, health care professionals, and the general public. The interest has continued to grow since the publications of two reports by the Institute of Medicine. The first report, in 1999, focused on all medical errors and introduced measures necessary to ensure a safer health care system.⁸⁵ The second report, in 2006, focused on reducing medication errors and adverse drug effects.⁸³ These reports and others reveal that medications errors represent up to 25% of all medical errors.⁴⁹ Many health care institutions address medication safety through their pharmacy and therapeutics (also commonly called drug and formulary), medication safety, patient safety, and quality improvement committees. Table 140–1 shows a timeline of some important developments in medication safety.