The safety of warfarin therapy in the nursing home setting.

Purpose: We examined the preventability of adverse warfarin-related events and potential adverse warfarin-related events ("near misses") in the nursing home setting.

Methods: We performed a cohort study of all long-term care residents of 25 nursing homes (bed size range, 90-360) in Connecticut during a 12-month observation period. The total number of residents in these facilities ranged from 2946 to 3212 per quarter.

Adverse drug events resulting from patient errors in older adults.

Objectives: To characterize the types of patient-related errors that lead to adverse drug events (ADEs) and identify patients at high risk of such errors.

Design: A subanalysis within a cohort study of Medicare enrollees.

Setting: A large multispecialty group practice.

Potential medication dosing errors in outpatient pediatrics.

Objective: To determine the prevalence of potential dosing errors of medication dispensed to children for 22 common medications.

Study Design: Using automated pharmacy data from 3 health maintenance organizations (HMOs), we randomly selected up to 120 children with a new dispensing prescription for each drug of interest, giving 1933 study subjects. Errors were defined as potential overdoses or potential underdoses.

Strategies for detecting adverse drug events among older persons in the ambulatory setting.

Objective: To examine various strategies for the identification of adverse drug events (ADEs) among older persons in the ambulatory clinical setting.

Design: A cohort study of Medicare enrollees (n = 31,757 per month) receiving medical care from a large multispecialty group practice during a 12-month observation period (July 1, 1999 through June 30, 2000).

Measurements: Possible drug-related incidents occurring in the ambulatory clinical setting were detected using signals from multiple sources.

Risk factors for adverse drug events among older adults in the ambulatory setting.

Objectives: To gather information on patient-level factors associated with risk of adverse drug events (ADEs) that may allow focus of prevention efforts on patients at high risk.

Design: Nested case-control study.

Setting: Large multispecialty group practice in New England.

Incidence and preventability of adverse drug events among older persons in the ambulatory setting.

Context: Adverse drug events, especially those that may be preventable, are among the most serious concerns about medication use in older persons cared for in the ambulatory clinical setting.

Objective: To assess the incidence and preventability of adverse drug events among older persons in the ambulatory clinical setting.

Design, Setting, And Patients: Cohort study of all Medicare enrollees (30 397 person-years of observation) cared for by a multispecialty group practice during a 12-month study period (July 1, 1999, through June 30, 2000), in which possible drug-related incidents occurring in the ambulatory clinical setting were detected using multiple methods, including reports from health care providers; review of hospital discharge summaries; review of emergency department notes; computer-generated signals; automated free-text review of electronic clinic notes; and review of administrative incident reports concerning medication errors.