Spotlight on Adverse Drug Reactions at Austin Health in 2023

Abstract

Aim: Adverse drug reactions (ADRs) are unintended, harmful consequences of medicine use. They are a leading cause of unplanned hospital admission and death. At Austin Health, ADRs are submitted to the multidisciplinary ADR committee for review before being reported to Therapeutic Goods Administration (TGA). This enhances patient safety by improving documentation and communication of ADRs and allows for analysis of local ADR trends. This audit describes ADR trends at Austin Health in 2023.

Method: Data from ADR reports submitted in 2023 were extracted from the pharmacy ADR database for analysis.

Results: There were 262 individual ADR reports reviewed by the ADR committee in 2023, slightly below the 5-year average of 273 reports per year. Voluntary reports by clinicians constituted 85% of ADRs. Of these, 81.5% were reported by pharmacists, 10% by doctors and 8.5% by nurses. The remaining 15% were identified via a new coding report to detect anaphylaxis (or similar) presentations to the emergency department. The severity of ADRs in 2023 was: 13% mild, 51% moderate, 31% severe, 5% fatal. More fatal ADRs were detected in 2023 than previous years, likely due to increased reporting of catastrophic bleeding events from emergency and intensive care clinicians. Skin reactions, anaphylaxis, angioedema/swelling and bleeding events were the most reported ADRs. The most common medicine classes implicated in causing ADRs were antimicrobials, anticoagulants/antiplatelets, immunosuppressants (including antineoplastics and immunomodulators), contrast agents and analgesics.

Conclusion: ADR reporting declined marginally at Austin Health in 2023 but there was increased reporting of fatal ADRs. Promoting ADR reporting to clinicians and utilising technology to detect more ADRs can help to better manage the risks associated with medicine use.

Impact: Detecting and reporting adverse drug reactions helps to identify safety issues with medicines and improve patient safety.