Academic detailing improves identification and reporting of adverse drug events

In a prospective, crossover study, we assessed the impact of a clinical pha rmacist on identification and reporting of adverse drug events (ADEs) in ho spitalized patients. The study was conducted on four units of a medical war d of a university hospital, with two units serving as test, the other two a s control units. After 12 months, test and control units were switched. In the test units, a pharmacist participated in daily ward rounds, solicited a dditional information from physicians and nurses, and reviewed the charts o f all patients. In control units, information on ADEs was based solely on v oluntary reports from physicians and nurses. A total of 1959 patients (941 in test, 1018 in control units) were hospitalized during the study period. In 137 test units patients, 224 ADEs (14.6%; 95%-CI: 12.3%-16.9%) were dete cted (8 severe, 60 moderate, 156 mild), while 25 ADEs (1 severe, 11 moderat e, 13 mild) occurring in 21 patients (2.1%; 95%-CI: 1.2%-3.0%) were reporte d from the control units (p < 0.0001). Of the ADEs in the test units, 51% w ere reported spontaneously, 39% were identified on rounds, and 10% by chart review. After changing the status of test and control units, the number of identified ADEs returned to preintervention levels. Clinical pharmacists a s part of the medical care team can improve the identification of ADEs whic h may ultimately translate into improved quality of care.