Adverse Drug Events and level of harm in Hospitalized Pediatric Patients in Palestine: A retrospective cohort study رسالة ماجستير

Abstract

Introduction: Patient safety is a major public health concern around the world. Adverse events increase mortality, morbidity, length of hospital stay and costs. Whereas adverse drug events (ADEs) resulted in higher medical costs, longer hospital stays, morbidity, and ascribable disability all around the world. In Palestine, there is limited data and research on adverse events, precisely medication error. There is an absence of system and tools to detecting the level of harm in terms of hospitalized pediatric patients even with the availability of traditional systems for reporting adverse drug events (ADEs). Aim of the study: To assess the level of pediatrics adverse drug events (ADE) and harm for pediatric patients during delivering medical treatment and to identify ADE related risk factors in Palestinian hospitals. Materials and Methods: A quantitative retrospective study conducted using the institute of healthcare improvement (IHI) Global Trigger Tool (GTT) for measuring adverse events (Pediatric ADE Patient Record Review Sheet). The study population comprised patients who had been hospitalized in pediatric wards at each of the six hospitals included in a five-month period from August, 2021 to December, 2021 at each hospital. A total of 600 pediatric patient charts were selected in a systematic random sampling method (100 records per hospital), reviewed, and evaluated according to the IHI GTT instructions. Results: Among the 600 patients 58.5 % were males and 41.5 % were females with mean age of 2.36 years. Overall, 291 triggers were identified, the most frequently detected trigger across all records was trigger T9 (Abrupt cessation of medication, n = 57), followed by trigger T8 (Rash, n=55) and trigger T1(use of anti-allergic drugs, n=52). The results show that one out of every four pediatric patients suffer harm in XIII Palestinian hospitals. Harm levels detected showed that 15.2% resulted in temporary harm that required an intervention (category E) followed by 5.5% that resulted in temporary harm that required prolonged hospitalization (category F). Hospital type, patient age and the length of stay were statistically significant having a correlation to the presence of ADEs and the level of harm with (p-value = 0.000), with regards to area/region the results showed that the occurrence of ADEs gave a statistically significant difference in favor of the south area (p-value = 0.002). Gender was not significantly associated with ADEs. Conclusion: Our study is the first to assess the adverse drug events occurrence in hospitalized pediatric patients in Palestine showing that one out of every four pediatric patients suffer harm in Palestinian hospitals with most ADEs resulting in temporary harm (Category E and F). Therefore, efforts should be directed towards improving the quality of care and applying policies in health sectors to ensure patient safety.