Adverse Drug Reactions vs. Adverse Drug Events – Detect and Avoid for Patient Safety

We are experiencing a health craze. Everybody is becoming health conscious and there is an abundance of herbs, supplements, lotions, etc. that people are using in their quest to rid themselves of, and prevent, ailments.

In addition, there are numerous prescription medications (almost 6,800) and countless over-the-counter drugs available in the US market. The use of so many substances in health care opens the door to possible interactions between substances, resulting in medication adverse effects. In the clinical space, terms such as adverse drug events (ADEs) and adverse drug reactions (ADRs) are used to describe some of the possible medication adverse effects that can result from drug use. But does the average person understand the meaning of these terms?

An adverse drug event (ADE) is defined as “an injury resulting from medical intervention related to a drug.” An ADE results from harms caused directly by the drug itself and include medication errors, ADRs, overdoses, and allergic reactions. An ADR, on the other hand, is a harmful and unintended response to a drug at normal doses and during normal use.

The Office of Disease Prevention and Health Promotion, part of the US Department of Health and Human Services, has named ADE prevention as an important patient safety priority in its National Action Plan for Adverse Drug Event Reporting. It noted that ADEs accounted for an estimated one-third of hospital adverse events and approximately 280,000 hospital admissions annually. The ADE Action Plan was established to coordinate multiple stakeholders and align Federal efforts in identifying common, preventable, and measurable ADEs that may result in significant patient harm. The goal is to jointly work towards reducing patient harm from these specific identified ADEs nationally.

Three types of ADEs were selected as the high-priority targets of the ADE Action Plan as they were identified as being common, clinically significant, preventable, and measurable. These are:

• Anticoagulants: primary ADE of concern – bleeding
• Diabetes agents: primary ADE of concern – hypoglycemia
• Opioids: primary ADE of concern – accidental overdoses/over-sedation/respiratory depression

The World Health Organization lists has reported that as many as 4 in 10 patients globally are harmed in primary and outpatient health care. Up to 80% of harm is preventable. The most detrimental errors are related to diagnosis, prescription and the use of medicines. As such, healthcare organizations are urged to utilize the ADE Action Plan and implement strategies to prevent medication adverse effects, especially from the three priority types of ADEs identified. Healthcare data management and healthcare technology can play a major role in this regard, and those organizations that proactively use healthcare technology to detect ADEs will be a step ahead in preventing them. Some ways in which healthcare data management and healthcare technology can be used in ADE detection and prevention include:

• Electronic exchange of health information, such as laboratory results and care (e.g., discharge) summaries. This can help to improve communication among the care team as a patient passes from one team to the next.
• Interoperability between laboratory and pharmacy systems to help prevent medication errors and medication adverse effects.
• Utilize electronic health records (EHRs) and patient engagement tools to provide patient-specific data that can inform appropriate clinical decisions by providers. EHRs and patient engagement tools can also provide clinical reminders and templates to prompt and facilitate recommended clinical practices. This could result in improvements in assessment, documentation, and collaborative treatment planning for patient risk factors and aberrant behaviors.
• Leverage EHR Meaningful Use requirements by incorporating Quality Measures specific to the three types of ADEs identified in the ADE Action Plan.

ADEs can also be prevented by improving patient compliance with their medication regimen. Incorporating remote monitoring solutions such as automated medication dispensers with reminders can improve patient compliance and also prevent potential overdoses especially in seniors with memory problems.

Patient safety is a priority for all healthcare organizations and medication adverse effects are a serious threat to this. By proactively incorporating healthcare technology to detect and avoid ADEs, organizations can increasingly prevent them and improve patient safety. Acuma Health can show you how to utilize technology for proactive prevention of medication adverse effects and improved patient safety.

Patient Generated Health Data from Smart Watches Ensures Accurate Seizure Tracking and Reporting

Epilepsy is one of the most common neurological illnesses with estimates of approximately 3.4 million people in the US experiencing active epilepsy in 2015. Despite advancements in treatment options and optimal medication management, nearly one-third of patients with epilepsy continue to have seizures. Seizures can negatively impact the overall quality of a person’s life due to their unpredictable nature, occurring at anytime and anywhere. Healthcare technology  has come to the aid of people who have seizures with the development of seizure monitors or seizure alert devices that can detect the onset of a seizure and make an alert so that the individual suffering the seizure can be aided quickly. Good seizure monitors can also provide clinicians with detailed seizure data that can be used in the management of epilepsy.

There are many seizure alert devices on the market including seizure bed alarms or mattress sensors, seizure bracelets and smart watches, and camera/video/infrared devices. The report, “Seizure detection, seizure prediction, and closed-loop warning systems in epilepsy,” explored various seizure detection and prediction systems and noted that accelerometers such as smart watches, detect changes in velocity and direction and may serve to detect motor seizures such as tonic–clonic or myoclonic seizures. The authors found that a smart watch was able to detect 7 out of 8 tonic–clonic seizures in a pilot study. It further noted that the SmartWatch, manufactured by Smart Monitor Inc.:

·         utilized pattern recognition and feature analysis in its built-in seizure detection algorithm

·         can synchronize with a smartphone application via Bluetooth to transmit seizure data to the user’s mobile phone

·         the app can then contact caretakers to alert them of ongoing seizures

It is evident that the patient generated health data collected by smart watches can provide accurate tracking and reporting of seizures. Seizure monitor technology and seizure alert devices are very useful for patient engagement and can produce improved patient outcomes through use of the patient generated health data that they provide. The use of seizure monitors such as smart watches allows for early intervention in patients experiencing seizures, preventing injury, lessening the severity of the seizure, and potentially preventing sudden unexpected death in epilepsy (SUDEP). Seizure monitors also provide objective data that can be leveraged by healthcare providers to adjust therapy, allowing for better management of the patient with epilepsy and resulting in cost savings from reduced hospitalizations.

To find out more about how smart watches and patient generated health data can ensure better management of patient care and costs, download the Guide to Leveraging Healthcare Technology to Improve Management of High Risk Patients.

Improve Patient Compliance Using Patient Generated Health Data and Patient Engagement

Although most commonly used in reference to medication, patient compliance or adherence is how well a patient follows a prescribed medical regimen or treatment plan as it is intended. The duration, frequency, and complexity of the behavior(s) required of the patient,all have an impact on the level of patient compliance.  

“Patient compliance is “the extent to which a person’s behavior (in terms of taking medications, following diets, or executing lifestyle changes) coincides with medical or health advice.”

Patient Compliance and Health Behavior Models

Patient non-compliance is a huge problem for the healthcare industry with reports of non-compliance costing the US economy between $100 and $300 billion dollars annually, inclusive of costs related to avoidable hospitalizations, nursing home admissions, and premature deaths. Another report places the figure even higher, at more than $564 billion dollars annually. To prevent the burden that non-compliance places on the healthcare industry and the economy, improving patient compliance must be a priority for all healthcare stakeholders.

7 Ways to Improve Patient Compliance

Improving patient compliance requires patients to become engaged in their healthcare, taking responsibility for their well-being, and actively participating in their health decisions. Healthcare stakeholders have begun implementing different patient engagement strategies and tools to improve patient compliance and resultant health outcomes. However, for any of these strategies to be successful, healthcare stakeholders need to work with patients as partners and actively engage them in the process. Healthcare organizations can improve patient compliance by:

1. Devising and implementing policies and procedures that support patient engagement as well as policies that help identify the non-compliant patients
2. Leveraging patient generated health data to assist in creating treatment decisions
3. Utilizing available healthcare technology
4. Facilitating patient education about their illnesses/conditions and how to manage their conditions, including medication management
5. Including the patient in the decision-making process surrounding their healthcare
6. Engaging and empowering caregivers to provide patient-centered care
7. Measuring progress and making changes where necessary

Simplifying the process surrounding the treatment regimen as much as possible will go a long way in improving patient compliance.

Patient Engagement to Improve Patient Compliance

An engaged patient is more likely to be a compliant patient. Healthcare organizations need to invest in patient engagement strategies to improve patient compliance and health outcomes. Policies must be developed and implemented to demonstrate the organization’s commitment to patient engagement and procedures for all staff to follow in engaging patients must also be implemented. Organizations must alsoensure that patients are treated with respect and that the organization feels welcoming to patients. The way patients are treated impacts how much they value the care they are provided by an organization which may also influence how well they comply with their treatment regimen.

“Engaged patients are better able to make informed decisions about their care options.”

– WHO Report

Organizations should also (i) ensure that care providers are afforded adequate time with each patient so that they can really communicate with the patient to find out their health status and how their lives outside of the healthcare setting may be impacting their compliance (ii) make it a policy for providers to ask questions such as “What medications are you taking?” and “How often do you take a particular medication?” Providers also need adequate time to educate patients on their chronic conditions and how best to manage them.

Healthcare organizations should utilize technology for patient engagement which can improve patient compliance – employ electronic health records (EHRs) to simplify the patient registration process, facilitate online bill payments, secure messaging, etc. EHRs can also help providers to easily keep track of and update patients’ medications thus facilitating the smooth coordination of a patient’s medications across all healthcare stakeholders. Healthcare organizations should develop patient portals that provide patients with relevant information and facilitate interaction with the healthcare team, and incorporate technology that can make the medication prescription and dispensing process simpler and faster, such as Computerized Physician Order Entry (CPOE) or electronic prescribing (e-prescribing) tools.

Patient Generated Health Data (PGHD) can be Used to Improve Patient Compliance

Patients nowadays are generating a tremendous amount of their health care data on their own through use of technologies such as wearable devices and mHealth apps. Patients are also being monitored remotely through registered medical devices such as the pacemaker and blood glucose monitors that monitor data on heart rate and blood glucose levels. Healthcare organizations should encourage healthcare providers to use PGHD to assist with creating treatment regimens for their patients. Utilizing PGHD in this manner can improve patient engagement and by extension, improve compliance as well. It has been shown that patients were more engaged when PGHD were used during their office visits compared to when PGHD were not used. Patients who see and feel that their healthcare providers are invested in their health and value their contributions including their PGHD, are more likely to be engaged and compliant with treatment plans.

In order to facilitate and encourage the use of PGHD in treatment and care, healthcare organizations can also harness and implement Digital Disease Management Solutions that provides a user-friendly environment to identify changes in disease condition, manage medication adherence and enable easy communication between patients and healthcare providers. Improving patient compliance is essential to reducing disease burden, the cost of chronic care and improving patient outcomes. Healthcare organizations need to take necessary steps to improve patient compliance by treating patients as partners and utilizing available healthcare technologies and PGHD.

Learn more about Acuma Health technologies to help you incorporate patient generated health data into your healthcare organizations or begin leveraging healthcare technology today with this guide.