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Assessment of adverse drug event recognition by emergency physicians in a French teaching hospital
  1. Lucien Roulet1,2,
  2. Françoise Ballereau2,3,
  3. Jean-Benoît Hardouin4,5,
  4. Anne Chiffoleau6,
  5. Leïla Moret4,
  6. Gilles Potel1,2,
  7. Nathalie Asseray2,3
  1. 1Emergency Department, Teaching Hospital, Nantes, France
  2. 2UPRES EA 3826 ‘Clinical and Experimental Therapeutics of Infectious Diseases’, Faculty of Medical Sciences, Nantes, France
  3. 3MEDQUAL, Medical Information, Evaluation and Public Health Unit, Teaching Hospital, Nantes, France
  4. 4UPRES EA 4275 ‘Biostatistics, Clinical Research and Subjective Measures in Health Sciences’, Faculty of Pharmaceutical Sciences, Nantes, France
  5. 5Plateform of Biometry, Teaching Hospital, Nantes, France
  6. 6Department of Clinical Pharmacology, Teaching Hospital, Nantes, France
  1. Correspondence to Dr Nathalie Asseray, Mailing address: EA3826, Faculté de Médecine, 1 rue Gaston Veil, Nantes 44035, France; nathalie.asseray{at}


Objectives The frequency and the severity of drug-related visits in emergency department (ED) make the improvement of adverse drug event (ADE) recognition a crucial issue. As part of a research project aiming to improve the diagnosis and the management of ADEs in ED, the authors conducted a pilot study whose primary objective was to assess ADE recognition by emergency physicians.

Methods The patients presenting to the ED were included at randomised time periods between 1 October 2007 and 31 March 2008 in this prospective cross-sectional study. The primary outcome was the frequency of ADEs that were attributed to a medication-related problem by the emergency physician.

Results A total of 423 patients met the inclusion criteria, of which 95 experienced an ADE (22.5%; 95% CI 18.6% to 26.7%). Emergency physicians correctly attributed 33 of these cases (34.7%; 95% CI 25.3% to 45.2%) to a medication-related problem. Of the 28 cases in which the ADE was considered as a ‘direct drug effect’ (29.5%; 95% CI 20.6% to 39.7%), 16 were correctly identified by emergency physicians (57.1%; 95% CI 37.2% to 75.5%). Of the 67 cases in which the ADE was considered as a ‘drug involvement in a multifactorial pathological condition’ (70.5%; 95% CI 60.3% to 79.4%), 17 were correctly attributed (25.4%; 95% CI 15.5% to 37.5%).

Conclusions ADEs are frequent in EDs and are not well recognised by emergency physicians, especially when the drug is involved in a multifactorial pathological condition.

  • Emergency
  • adverse drug events
  • risk management
  • pharmacoepidemiology
  • assessment
  • healthcare quality
  • clinical care
  • clinical management
  • diagnosis
  • research
  • epidemiology
  • statistics
  • teaching
  • bacterial
  • infection
  • clinical

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  • Prior presentations Part of these results were presented in the ACCP congress, April 2009, Orlando, USA.

  • Competing interests None.

  • Ethics approval The project was approved by the GNEDS (Groupe Nantais d'Ethique dans le Domaine de la Santé).

  • Provenance and peer review Not commissioned; externally peer reviewed.