Adverse drug events are unfavourable occurrences related to the use and misuse of medications. It has been estimated that adverse drug events account for more than 17 million emergency department visits and almost 9 million hospital admissions annually in the United States. A cost-of-illness model published in 2001 estimated that annual costs associated with morbidity and mortality secondary to adverse drug events exceeded USdollar177 billion. Until recently, the effects of adverse drug events in Canada had not been characterized, but it is now evident that significant morbidity, mortality, and economic impact can be related to adverse drug events. More specifically, it has been estimated that as many as 25% of general medicine admissions and 12% of visits by adults to the emergency department in this country are directly related to adverse drug events, of which 70% are deemed preventable. In the Canadian Adverse Events Study, 7.5% of all inpatients experienced an adverse event during their hospital stay and nearly 24% of the events were related to drug or fluid administration.Finally, in another study, 23% of patients experienced an adverse event within 30 days after hospital discharge, 72% of the events were associated with drugs, and 50% of the events were preventable. These staggering data suggest that we have underestimated the magnitude of this problem but also that we are presented with a tremendous opportunity to explore and implement strategies for both inpatients and outpatients to reduce these events. In this issue of the CJHP, we have 3 papers that once again remind us of the impact of adverse drug events and drug-related problems in hospital patients.
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