Arch Intern Med
-
Adverse drug events (ADEs) may lead to serious injury and may result in malpractice claims. While ADEs resulting in claims are not representative of all ADEs, such data provide a useful resource for studying ADEs. Therefore, we conducted a review of medication-related malpractice claims to study their frequency, nature, and costs and to assess the human factor failures associated with preventable ADEs. We also assessed the potential benefits of proved effective ADE prevention strategies on ADE claims prevention. ⋯ Adverse drug events associated with malpractice claims were often severe, costly, and preventable, and about half occurred in outpatients. Many interventions could potentially have prevented ADEs, with error proofing and process standardization covering the greatest proportion of events.
-
The prevalence, health care expenditures, and hospitalization experiences are important considerations among elderly populations with multiple chronic conditions. ⋯ The risk of an avoidable inpatient admission or a preventable complication in an inpatient setting increases dramatically with the number of chronic conditions. Better primary care, especially coordination of care, could reduce avoidable hospitalization rates, especially for individuals with multiple chronic conditions.
-
Women experience rapid bone loss following menopause. Currently available guidelines recommend lifestyle counseling and pharmacotherapy for osteoporosis prevention and treatment in postmenopausal women. ⋯ Women are particularly at risk for osteoporosis as they experience menopause, with estimates of 20 million women with osteoporosis or osteopenia. Despite the high prevalence, our study showed that only 10% of all visits were associated with 1 or more AOM therapy prescribed, provided, or continued in 1997 and 1998. These data also suggest that women with Medicaid or self-pay status were less likely to receive AOMs than women with other forms of insurance. The status of AOM therapy and lifestyle counseling in ambulatory care practice in the United States during 1997 and 1998 was less than optimal.