Adverse drug events in hospitalized patients - A comparison of doctors, nurses and patients as sources of reports

Objective: This study investigated the relative value of adverse drug event s reported by doctors, nurses and patients. Methods: The study was conducted on a total of four wards: the paediatric a nd internal medicine wards (including geriatric patients) of two peripheral hospitals in the Netherlands. Adverse drug events were collected by sponta neous reporting (doctor and nurse reports) and by daily ward visits, during which the patients were interviewed by a hospital pharmacist (patient repo rts). Criteria for relative value of the reported adverse drug events were the number of potentially serious reactions, the number of reactions not me ntioned in the patient information leaflet and the number of reactions repo rted to new drugs (5 years or less on the Dutch market). No formal causalit y assessment was applied. Results: Over a period of 2 months in 1996 (Hospital I) and 2 months in 199 7 (Hospital II) a total of 620 patients were included in the study and adve rse drug events were reported in 179 (29%) of these cases. Doctors reported a statistically significant larger number of serious (26% of all doctor re ports; odds ratio (OR) 3.2; confidence interval (CI) 1.2-8.7) and unknown ( 39%; OR 2.5; CI 1.0-6.0) adverse drug events than patients themselves durin g the daily ward visit. Doctors also reported more serious and unknown adve rse drug events than nurses. Adverse reactions to new drugs were reported d uring the daily ward visit only (8% of all daily ward visit reports). Conclusion: This study reconfirms that doctors are the main source for repo rts of serious and unknown adverse drug events in hospitalized patients. Ho wever, patients themselves seem to report more adverse reactions to new dru gs (during the daily ward visit). By focusing on patients using new drugs; the daily ward visit might become cost-effective. This needs to be explored in future studies.