Grant: New Investigator Salary Award - PA: Drug Safety and Effectiveness - Drug Safety

Adverse drug reactions are unintended and harmful effects caused by medications. They are a common cause of preventable adverse events in medicine. In Canada, adverse drug reactions cause 720,000 Emergency Department (ED) visits each year. Adverse drug reactions are not easy to recognize. In fact, they are misdiagnosed 39-49% of the time in the ED, and the consequences can be serious. If the medication causing the problem is not stopped, the patient's condition can worsen and may even lead to death. Past attempts to develop tools to help community doctors prescribe medications in a safer manner and to help health care professionals identify and treat adverse drug reactions have not been very successful. This is because the resources required to make the diagnosis and readjust the medications are often not available in the outpatient setting. The ED is the ideal setting to address these problems. EDs have all the necessary resources, and patients with the most severe adverse drug reactions frequently go to the ED. In a previous study, we developed a user-friendly screening tool, similar to a checklist, that accurately identifies patients in the ED with adverse drug reactions. Our goal is to evaluate this screening tool on a larger scale to confirm its safety and accuracy. We propose to do this in a study enrolling 3550 patients from seven EDs in three provinces. Nurses will apply the screening tool we will evaluate, and pharmacists will assess all patients to determine who has an adverse drug reaction. We will then determine how many patients diagnosed with adverse drug reactions the screening tool has detected, how easy it is to use, how reliable it is, and what its potential impact is on clinical practice. Once we have evaluated the screening tool, we plan to roll out it out in EDs throughout Canada and internationally. We believe that this will lead to better patient care, less patient suffering and decrease the cost of health care.