Proposed Targets Announced to Reduce Adverse Drug Events

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By Don Wright, MD, MPH, Deputy Assistant Secretary for Health, Director, ODPHP

On October 20, 2016, we announced proposed targets for the National Action Plan for Adverse Drug Event Prevention (ADE Action Plan). The plan calls for coordination among federal and non-federal stakeholders to reduce adverse drug events that are considered to be common, clinically significant, preventable, and measurable; resulting from opioids, anticoagulants, and diabetes agents; and occurring largely in high-risk populations.

Adverse drug events account for over 3.5 million physician office visits and an estimated 1 million emergency department visits annually. Further, an estimated 1 in 3 of all adverse events while patients are in the hospital are the result of adverse drug events, affecting about 2 million hospital stays each year. Approximately 2 in 3 of adverse drug events that occur in hospitals are related to opioids, anticoagulants, or diabetes agents. Imagine the dramatic improvements in patient safety that could be achieved if we could minimize the occurrence of adverse drug events from these three classes of medications.

The proposed targets aim to reduce adverse drug events from anticoagulants, diabetes agents, and opioid analgesics in inpatient and outpatient setting by 10 percent by the year 2020:

Inpatient settings:

  • Reduce adverse drug events (unintended measurable harm or injury) from anticoagulants by 10% from 2014 baseline data
  • Reduce adverse drug events (unintended measurable harm or injury) from diabetes agents by 10% from 2014 baseline data
  • Reduce adverse drug events (unintended measurable harm or injury) from opioid analgesics by 10% from 2016 baseline data

Outpatient settings:

  • Reduce U.S. emergency department visits for adverse drug events (unintended measurable harm or injury) from anticoagulants by 10% from 2014 baseline data
  • Reduce U.S. emergency department visits for adverse drug events (unintended measurable harm or injury) from diabetes agents by 10% from 2014 baseline data
  • Reduce U.S. emergency department visits for adverse drug events (unintended measurable harm or injury) from opioid analgesics by 10% from 2014 baseline data

These targets build on a federal interagency initiative that was recently recognized by through the receipt of a Pinnacle Award from the American Pharmacists Association in September 2016. The initiative led to unprecedented national progress in the systematic reduction of adverse drug events, the largest single category of hospital harm. Within HHS, the ADE Action Plan along with AHRQ’s National Scorecard, CMS’s Quality Improvement Organization program work and the Hospital Engagement Networks, the Partnership for Patients initiative, and HRSA’s Patient Safety and Clinical Pharmacy Services Collaborative were recognized for helping to reduce adverse drug events by 40 percent since 2010.

It is not every day that we get to celebrate an accomplishment like this one. We are honored that APhA  chose to recognize HHS for the agency’s leadership in reducing adverse drug events. APhA’s video from the Pinnacle Award ceremony highlights this and other notable accomplishments from this collaborative initiative:

The ADE Action Plan helped us to define common goals and objectives for the programs across the federal government that are working to reduce adverse drug events. The success of the ADE Action Plan will depend on ongoing coordination and collaboration across the federal government and among government agencies, national experts, and key public and private stakeholders. The proposed targets that we announced today will help to continue this coordination and collaboration to further reduce adverse drug events related to opioids, anticoagulants, and diabetes agents. We invite interested public and private professionals, organizations, and consumer representatives to submit written comments by November 21, 2016. Please review the federal register notice for instructions on how to submit your comments and let us know your thoughts on continuing this important work.

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