Exploring patient participation in reducing health-care-related safety risks

Patient safety, rights and medication safety in primary care in Poland
ChApTER 5.
pATIENT SAFETY, RIGhTS AND
MEDICATION SAFETY IN pRIMARY CARE
IN pOLAND
Basia Kutryba, Jarosław Woroń, Halina Kutaj-Wąsikowska, Andrzej Warunek
Introduction
Many studies focus on medication safety as one of the fundamental areas of patient
safety. Adverse drug events (ADEs) are the most frequent type of adverse events. There
is often confusion, however, between ADEs and adverse drug reactions (ADRs). They
are defined, respectively, as follows:
» ADE – every adverse event related to medicine use (pharmacotherapy); there is not
necessarily a cause–effect relationship involved; and
» ADR – every event has a cause–effect relationship resulting from medication use; the
relationship between cause and effect can be determined as resulting directly from
the medicine use − anaphylactic shock during penicillin administration, for example.
ADEs therefore include ADRs and other adverse events related to medication use,
prescribing, storage and design.
Several national multicentre studies of adverse events in different countries reveal that
between 6.3% and 12.9% of hospitalized patients suffer at least one adverse event during
their admissions and that between 10.8% and 38.7% are caused by medicines. Between
30.3% and 47% of these ADEs appear to be consequences of medication errors and may
therefore be considered to be preventable.
Available data show that the morbidity and mortality associated with medication errors
in Europe are of a similar magnitude to those in the United States and other countries.
The reported incidence of preventable ADEs in European hospitals ranges from 0.4%
to 7.3% of all hospitalizations. European evidence on medication errors is presented
in the following sections in the format of the different European studies on ADEs,
but the review of the research literature shows that only a few studies are related to
pharmacotherapy and the use of medicines in PHC.
These studies reveal that ADEs are mostly caused by errors in prescription and drug
administration or lack of patient compliance and are probably more frequent than in
hospital settings because drug consumption in PHC is greater, although data on this are
scarce and fragmented.
The European research on preventable ADEs occurring in primary care and leading to
hospital admissions has shown that between 0.9% and 4.7% of all hospital admissions
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