Drug Safety

, Volume 30, Issue 5, pp 379–407 | Cite as

Drug-Related Problems in Hospitals

A Review of the Recent Literature
  • Anita Krähenbühl-Melcher
  • Raymond Schlienger
  • Markus Lampert
  • Manuel Haschke
  • Jürgen Drewe
  • Stephan KrähenbühlEmail author
Review Article


Problems associated with pharmacotherapy (in particular, medication errors and adverse drug events) are frequent and are associated with increased costs for treatment.

Analysis of original publications published between 1990 and 2005 on the topics of medication errors and/or adverse drug events in hospitalised patients, focusing on the frequency of, risk factors for and avoidance of such problems associated with pharmacotherapy, indicated that medication errors occurred in a mean of 5.7% of all episodes of drug administration, but with a high variability among the 35 studies retrieved. This variability was explained by the methods by which medication errors were detected (systematic screening of patients versus chart review or spontaneous reporting) and by the way drugs were administered (intravenously administered drugs are associated with the highest error frequencies). Errors occurred throughout the whole medication process, with administration errors accounting for more than half of all errors. Important risk factors included insufficient pharmacological knowledge of health professionals, errors in the patient charts or documentation by nurses and inadequate pharmacy services.

Adverse events or reactions, on the other hand, affected 6.1 patients per 100 hospitalised and also showed a high variability among the 46 studies retrieved. This variability could also be explained by the different methods of assessment of the frequency of adverse drug events or reactions, as well as by the different wards on which the studies were performed. Important risk factors for adverse drug events or reactions included polypharmacy, female sex, drugs with a narrow therapeutic range, renal elimination of drugs, age >65 years and use of anticoagulants or diuretics.

Since medication errors are strong risk factors for preventable adverse drug events or reactions, strategies have to be put in place for their reduction. Such strategies include ensuring that all persons involved in the medication process (nurses, pharmacists and physicians) have good pharmacological knowledge, computerisation of the entire medication process, and the engagement of a sufficient number of clinical pharmacists on the wards.


Adverse Drug Reaction Medication Error Adverse Drug Event Clinical Pharmacist Computerise Physician Order Entry 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work was supported by a grant from the Swiss National Science Foundation to S.K. (310000-112483/1). The authors have no conflicts of interest that are directly relevant to the content of this manuscript.


  1. 1.
    Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events: implications for prevention. ADE Prevention Study Group. JAMA 1995; 274(1): 29–34PubMedCrossRefGoogle Scholar
  2. 2.
    Fattinger K, Roos M, Vergeres P, et al. Epidemiology of drug exposure and adverse drug reactions in two Swiss departments of internal medicine. Br J Clin Pharmacol 2000 Feb; 49(2): 158–67PubMedCrossRefGoogle Scholar
  3. 3.
    Moore N, Lecointre D, Noblet C, et al. Frequency and cost of serious adverse drug reactions in a department of general medicine. Br J Clin Pharmacol 1998 Mar; 45(3): 301–8PubMedCrossRefGoogle Scholar
  4. 4.
    Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 1998 Apr 15; 279(15): 1200–5PubMedCrossRefGoogle Scholar
  5. 5.
    Bond CA, Raehl CL, Franke T. Medication errors in United States hospitals. Pharmacotherapy 2001 Sep; 21(9): 1023–36PubMedCrossRefGoogle Scholar
  6. 6.
    Classen DC, Pestotnik SL, Evans RS, et al. Adverse drug events in hospitalized patients: excess length of stay, extra costs, and attributable mortality. JAMA 1997 Jan 22–29; 277(4): 301–6PubMedCrossRefGoogle Scholar
  7. 7.
    van den Bemt PM, Egberts TC, de Jong-van den Berg LT, et al. Drug-related problems in hospitalised patients. Drug Saf 2000 Apr; 22(4): 321–33PubMedCrossRefGoogle Scholar
  8. 8.
    Bates DW, Spell N, Cullen DJ, et al. The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group JAMA 1997 Jan 22–29; 277(4): 307–11PubMedCrossRefGoogle Scholar
  9. 9.
    Bordet R, Gautier S, Le Louet H, et al. Analysis of the direct cost of adverse drug reactions in hospitalised patients. Eur J Clin Pharmacol 2001 Mar; 56(12): 935–41PubMedCrossRefGoogle Scholar
  10. 10.
    Gautier S, Bachelet H, Bordet R, et al. The cost of adverse drug reactions. Expert Opin Pharmacother 2003 Mar; 4(3): 319–26PubMedCrossRefGoogle Scholar
  11. 11.
    Nebeker JR, Barach P, Samore MH. Clarifying adverse drug events: a clinician’s guide to terminology, documentation, and reporting. Ann Intern Med 2004; 140(10): 795–801PubMedGoogle Scholar
  12. 12.
    Leape LL. Preventing adverse drug events. Am J Health Syst Pharm 1995; 52(4): 379–82PubMedGoogle Scholar
  13. 13.
    American Society of Hospital Pharmacy. ASHP guidelines on adverse drug reaction monitoring and reporting. Am J Health Syst Pharm 1995; 52(4): 417–9Google Scholar
  14. 14.
    Cox Jr PM, D’Amato S, Tillotson DJ. Reducing medication errors. Am J Med Qual 2001 May–Jun; 16(3): 81–6PubMedCrossRefGoogle Scholar
  15. 15.
    Lesar TS, Lomaestro BM, Pohl H. Medication-prescribing errors in a teaching hospital: a 9-year experience. Arch Intern Med 1997 Jul 28; 157(14): 1569–76PubMedCrossRefGoogle Scholar
  16. 16.
    Bond CA, Raehl CL, Franke T. Clinical pharmacy services, hospital pharmacy staffing, and medication errors in United States hospitals. Pharmacotherapy 2002 Feb; 22(2): 134–47PubMedCrossRefGoogle Scholar
  17. 17.
    Bowman L, Carlstedt BC, Black CD. Incidence of adverse drug reactions in adult medical inpatients. Can J Hosp Pharm 1994 Oct; 47(5): 209–16PubMedGoogle Scholar
  18. 18.
    Fortescue EB, Kaushal R, Landrigan CP, et al. Prioritizing strategies for preventing medication errors and adverse drug events in pediatric inpatients. Pediatrics 2003 Apr; 111 (4 Pt 1): 722–9PubMedCrossRefGoogle Scholar
  19. 19.
    Classen DC, Pestotnik SL, Evans RS, et al. Computerized surveillance of adverse drug events in hospital patients. JAMA 1991 Nov 27; 266(20): 2847–51PubMedCrossRefGoogle Scholar
  20. 20.
    Hardmeier B, Braunschweig S, Cavallaro M, et al. Adverse drug events caused by medication errors in medical inpatients. Swiss Med Wkly 2004; 134(45–46): 664–70PubMedGoogle Scholar
  21. 21.
    Schumock GT, Thornton JP, Witte KW. Comparison of pharmacy-based concurrent surveillance and medical record retrospective reporting of adverse drug reactions. Am J Hosp Pharm 1991 Sep; 48(9): 1974–6PubMedGoogle Scholar
  22. 22.
    Leape LL, Brennan TA, Laird N, et al. The nature of adverse events in hospitalized patients: results of the Harvard Medical Practice Study II. N Engl J Med 1991 Feb 7; 324(6): 377–84PubMedCrossRefGoogle Scholar
  23. 23.
    Lindley CM, Tully MP, Paramsothy V, et al. Inappropriate medication is a major cause of adverse drug reactions in elderly patients. Age Ageing 1992 Jul; 21(4): 294–300PubMedCrossRefGoogle Scholar
  24. 24.
    Schneider JK, Mion LC, Frengley JD. Adverse drug reactions in an elderly outpatient population. Am J Hosp Pharm 1992 Jan; 49(1): 90–6PubMedGoogle Scholar
  25. 25.
    Madsen JJ. Comparison of concurrent and retrospective methods of detecting adverse drug reactions. Am J Hosp Pharm 1993 Dec; 50(12): 2556–7PubMedGoogle Scholar
  26. 26.
    Chan TY, Critchley JAJH. Reporting of adverse drug reactions in relation to general medical admissions to a teaching hospital in Hong Kong. Pharmacoepidemiol Drug Saf 1994; 3: 85–9CrossRefGoogle Scholar
  27. 27.
    Nazario M, Feliu JF, Rivera GC. Adverse drug reactions: the San Juan Department of Veterans Affairs Medical Center experience. Hosp Pharm 1994 Mar; 29(3): 244–6, 9–50PubMedGoogle Scholar
  28. 28.
    Pearson TF, Pittman DG, Longley JM, et al. Factors associated with preventable adverse drug reactions. Am J Hosp Pharm 1994 Sep 15; 51(18): 2268–72PubMedGoogle Scholar
  29. 29.
    van Kraaij DJ, Haagsma CJ, Go IH, et al. Drug use and adverse drug reactions in 105 elderly patients admitted to a general medical ward. Neth J Med. 1994 May; 44(5): 166–73PubMedCrossRefGoogle Scholar
  30. 30.
    Orsini MJ, Orsini PA, Thorn DB, et al. An ADR surveillance program: increasing quality, number of incidence reports. Formulary 1995 Aug; 30(8): 454–61PubMedGoogle Scholar
  31. 31.
    Hall M, McCormack P, Arthurs N, et al. The spontaneous reporting of adverse drug reactions by nurses. Br J Clin Pharmacol 1995; 40(2): 173–5PubMedCrossRefGoogle Scholar
  32. 32.
    Bates DW, Boyle DL, Vander Vliet MB, et al. Relationship between medication errors and adverse drug events. J Gen Intern Med 1995; 10(4): 199–205PubMedCrossRefGoogle Scholar
  33. 33.
    Wu FL, Yang CC, Shen LJ, et al. Adverse drug reactions in a medical ward. J Formos Med Assoc 1996 Mar; 95(3): 241–6PubMedGoogle Scholar
  34. 34.
    Smith CC, Bennett PM, Pearce HM, et al. Adverse drug reactions in a hospital general medical unit meriting notification to the Committee on Safety of Medicines. Br J Clin Pharmacol 1996 Oct; 42(4): 423–9PubMedCrossRefGoogle Scholar
  35. 35.
    Bowman L, Carlstedt BC, Hancock EF, et al. Adverse drug reaction (ADR) occurrence and evaluation in elderly inpatients. Pharmacoepidemiol Drug Saf 1996; 5(1): 9–18PubMedCrossRefGoogle Scholar
  36. 36.
    Cullen DJ, Sweitzer BJ, Bates DW, et al. Preventable adverse drug events in hospitalized patients: a comparative study of 406 intensive care and general care units. Crit Care Med 1997; 25(8): 1289–97PubMedCrossRefGoogle Scholar
  37. 37.
    Gray SL, Sager M, Lestico MR, et al. Adverse drug events in hospitalized elderly. J Gerontol Biol Sci Med Sci 1998; 53(1): M59–63CrossRefGoogle Scholar
  38. 38.
    Gholami K, Shalviri G. Factors associated with preventability, predictability, and severity of adverse drug reactions. Ann Pharmacother 1999 Feb; 33(2): 236–40PubMedCrossRefGoogle Scholar
  39. 39.
    Schlienger RG, Luscher TF, Schoenenberger RA, et al. Academic detailing improves identification and reporting of adverse drug events: retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals. Pharm World Sci 1999; 21(3): 110–5PubMedCrossRefGoogle Scholar
  40. 40.
    Tegeder I, Levy M, Muth-Selbach U, et al. Retrospective analysis of the frequency and recognition of adverse drug reactions by means of automatically recorded laboratory signals. Br J Clin Pharmacol 1999 May; 47(5): 557–64PubMedCrossRefGoogle Scholar
  41. 41.
    van den Bemt PM, Egberts AC, Lenderink AW, et al. Adverse drug events in hospitalized patients: a comparison of doctors, nurses and patients as sources of reports. Eur J Clin Pharmacol 1999 Apr; 55(2): 155–8PubMedCrossRefGoogle Scholar
  42. 42.
    Bates DW, Miller EB, Cullen DJ, et al. Patient risk factors for adverse drug events in hospitalized patients. ADE Prevention Study Group. Arch Intern Med 1999; 159(21): 2553–60PubMedCrossRefGoogle Scholar
  43. 43.
    Dormann H, Muth-Selbach U, Krebs S, et al. Incidence and costs of adverse drug reactions during hospitalisation: computerised monitoring versus stimulated spontaneous reporting. Drug Saf 2000 Feb; 22(2): 161–8PubMedCrossRefGoogle Scholar
  44. 44.
    Suh DC, Woodall BS, Shin SK, et al. Clinical and economic impact of adverse drug reactions in hospitalized patients. Ann Pharmacother 2000 Dec; 34(12): 1373–9PubMedCrossRefGoogle Scholar
  45. 45.
    Lagnaoui R, Moore N, Fach J, et al. Adverse drug reactions in a department of systemic diseases-oriented internal medicine: prevalence, incidence, direct costs and avoidability. Eur J Clin Pharmacol 2000 May; 56(2): 181–6PubMedCrossRefGoogle Scholar
  46. 46.
    Thomas EJ, Brennan TA. Incidence and types of preventable adverse events in elderly patients: population based review of medical records. BMJ 2000; 320(7237): 741–4PubMedCrossRefGoogle Scholar
  47. 47.
    Kaushal R, Bates DW, Landrigan C, et al. Medication errors and adverse drug events in pediatrie inpatients. JAMA 2001 Apr 25; 285(16): 2114–20PubMedCrossRefGoogle Scholar
  48. 48.
    Cox AR, Anton C, Goh CH, et al. Adverse drug reactions in patients admitted to hospital identified by discharge ICD-10 codes and by spontaneous reports. Br J Clin Pharmacol 2001 Sep; 52(3): 337–9PubMedCrossRefGoogle Scholar
  49. 49.
    Senst BL, Achusim LE, Genest RP, et al. Practical approach to determining costs and frequency of adverse drug events in a health care network. Am J Health Syst Pharm 2001; 58(12): 1126–32PubMedGoogle Scholar
  50. 50.
    Thuermann PA, Windecker R, Steffen J, et al. Detection of adverse drug reactions in a neurological department: comparison between intensified surveillance and a computer-assisted approach. Drug Saf 2002; 25(10): 713–24PubMedCrossRefGoogle Scholar
  51. 51.
    Vargas E, Terleira A, Hernando F, et al. Effect of adverse drug reactions on length of stay in surgical intensive care units. Crit Care Med 2003 Mar; 31(3): 694–8PubMedCrossRefGoogle Scholar
  52. 52.
    Egger T, Dormann H, Ahne G, et al. Identification of adverse drug reactions in geriatric inpatients using a computerised drug database. Drugs Aging 2003; 20(10): 769–76PubMedCrossRefGoogle Scholar
  53. 53.
    Somers A, Petrovic M, Robays H, et al. Reporting adverse drug reactions on a geriatric ward: a pilot project. Eur J Clin Pharmacol 2003 Feb; 58(10): 707–14PubMedGoogle Scholar
  54. 54.
    Briant R, Ali W, Lay-Yee R, et al. Representative case series from public hospital admissions 1998, I: drug and related therapeutic adverse events. N Z Med J 2004; 117(1188): U747PubMedGoogle Scholar
  55. 55.
    Rothschild JM, Landrigan CP, Cronin JW, et al. The Critical Care Safety Study: the incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med 2005; 33(8): 1694–700PubMedCrossRefGoogle Scholar
  56. 56.
    Nebeker JR, Hoffman JM, Weir CR, et al. High rates of adverse drug events in a highly computerized hospital. Arch Intern Med 2005; 165(10): 1111–6PubMedCrossRefGoogle Scholar
  57. 57.
    Gurwitz JH, Field TS, Judge J, et al. The incidence of adverse drug events in two large academic long-term care facilities. Am J Med 2005; 118(3): 251–8PubMedCrossRefGoogle Scholar
  58. 58.
    Hartwig SC, Denger SD, Schneider PJ. Severity-indexed, incident report-based medication error-reporting program. Am J Hosp Pharm 1991 Dec; 48(12): 2611–6PubMedGoogle Scholar
  59. 59.
    Bates DW, Leape LL, Petrycki S. Incidence and preventability of adverse drug events in hospitalized adults. J Gen Intern Med. 1993 Jun; 8(6): 289–94PubMedCrossRefGoogle Scholar
  60. 60.
    Schumock GT, Guenette AJ, Keys TV, et al. Prescribing errors for patients about to be discharged from a university teaching hospital. Am J Hosp Pharm 1994 Sep 15; 51(18): 2288, 90PubMedGoogle Scholar
  61. 61.
    Shaughnessy AF, D’Amico F. Long-term experience with a program to improve prescription-writing skills. Fam Med 1994 Mar; 26(3): 168–71PubMedGoogle Scholar
  62. 62.
    Nettleman MD, Nelson AP. Adverse occurrences during hospitalization on a general medicine service. Clin Perform Qual Health Care 1994 Apr–Jun; 2(2): 67–72PubMedGoogle Scholar
  63. 63.
    Dean BS, Allan EL, Barber ND, et al. Comparison of medication errors in an American and a British hospital. Am J Health Syst Pharm 1995 Nov 15; 52(22): 2543–9PubMedGoogle Scholar
  64. 64.
    Borel JM, Rascati KL. Effect of an automated, nursing unit-based drug-dispensing device on medication errors. Am J Health Syst Pharm 1995; 52(17): 1875–9PubMedGoogle Scholar
  65. 65.
    Ridge KW, Jenkins DB, Noyce PR, et al. Medication errors during hospital drug rounds. Qual Health Care 1995; 4(4): 240–3PubMedCrossRefGoogle Scholar
  66. 66.
    Lesar TS, Briceland L, Stein DS. Factors related to errors in medication prescribing. JAMA 1997 Jan 22–29; 277(4): 312–7PubMedCrossRefGoogle Scholar
  67. 67.
    Mehrtens T, Carstens G. Medikationsfehler auf einer Station. Krankenhaus Pharmazie 1997; 18: 168–70Google Scholar
  68. 68.
    Lacasa C, Cot R, Roure C, et al. Medication errors in a general hospital. Eur J Hosp Pharm 1998; 4: 35–40Google Scholar
  69. 69.
    McNally KM, Sunderland BV. No-blame medication administration error reporting by nursing staff at a teaching hospital in Australia. Int J Pharm Pract 1998; 6: 67–71CrossRefGoogle Scholar
  70. 70.
    Raschke RA, Gollihare B, Wunderlich TA, et al. A computer alert system to prevent injury from adverse drug events: development and evaluation in a community teaching hospital. JAMA 1998 Oct 21; 280(15): 1317–20PubMedCrossRefGoogle Scholar
  71. 71.
    Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA 1998; 280(15): 1311–6PubMedCrossRefGoogle Scholar
  72. 72.
    Taxis K, Dean B, Barber N. Hospital drug distribution systems in the UK and Germany: a study of medication errors. Pharm World Sci 1999 Feb; 21(1): 25–31PubMedCrossRefGoogle Scholar
  73. 73.
    Flaatten H, Hevroy O. Errors in the intensive care unit (ICU): experiences with an anonymous registration. Acta Anaesthesiol Scand 1999 Jul; 43(6): 614–7PubMedCrossRefGoogle Scholar
  74. 74.
    Leape LL, Cullen DJ, Clapp MD, et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA 1999 Jul 21; 282(3): 267–70PubMedCrossRefGoogle Scholar
  75. 75.
    Tissot E, Cornette C, Demoly P, et al. Medication errors at the administration stage in an intensive care unit. Intensive Care Med 1999 Apr; 25(4): 353–9PubMedCrossRefGoogle Scholar
  76. 76.
    Bates DW, Teich JM, Lee J, et al. The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc 1999; 6(4): 313–21PubMedCrossRefGoogle Scholar
  77. 77.
    Calabrese AD, Erstad BL, Brandi K, et al. Medication administration errors in adult patients in the ICU. Intensive Care Med 2001 Oct; 27(10): 1592–8 407PubMedCrossRefGoogle Scholar
  78. 78.
    Barker KN, Flynn EA, Pepper GA, et al. Medication errors observed in 36 health care facilities. Arch Intern Med 2002 Sep 9; 162(16): 1897–903PubMedCrossRefGoogle Scholar
  79. 79.
    van den Bemt PM, Fijn R, van der Voort PH, et al. Frequency and determinants of drug administration errors in the intensive care unit. Crit Care Med 2002; 30(4): 846–50PubMedCrossRefGoogle Scholar
  80. 80.
    LaPointe NM, Jollis JG. Medication errors in hospitalized cardiovascular patients. Arch Intern Med 2003 Jun 23; 163(12): 1461–6PubMedCrossRefGoogle Scholar
  81. 81.
    Taxis K, Barber N. Ethnographic study of incidence and severity of intravenous drug errors. BMJ 2003 Mar 29; 326(7391): 684–7PubMedCrossRefGoogle Scholar
  82. 82.
    Greengold NL, Shane R, Schneider P, et al. The impact of dedicated medication nurses on the medication administration error rate: a randomized controlled trial. Arch Intern Med 2003; 163(19): 2359–67PubMedCrossRefGoogle Scholar
  83. 83.
    Tissot E, Cornette C, Limat S, et al. Observational study of potential risk factors of medication administration errors. Pharm World Sci 2003; 25(6): 264–8PubMedCrossRefGoogle Scholar
  84. 84.
    Wirtz V, Taxis K, Barber ND. An observational study of intravenous medication errors in the United Kingdom and in Germany. Pharm World Sci 2003; 25(3): 104–11PubMedCrossRefGoogle Scholar
  85. 85.
    Herout PM, Erstad BL. Medication errors involving continuously infused medications in a surgical intensive care unit. Crit Care Med 2004; 32(2): 428–32PubMedCrossRefGoogle Scholar
  86. 86.
    Taxis K, Barber N. Incidence and severity of intravenous drug errors in a German hospital. Eur J Clin Pharmacol. Epub 2003 Oct 29 2004; 59(11): 815–7Google Scholar
  87. 87.
    van Gijssel-Wiersma DG, van den Bemt PM, Walenbergh-van Veen MC. Influence of computerised medication charts on medication errors in a hospital. Drug Saf. 2005; 28(12): 1119–29PubMedCrossRefGoogle Scholar
  88. 88.
    Egger SS, Drewe J, Schlienger RG. Potential drug-drug interactions in the medication of medical patients at hospital discharge. Eur J Clin Pharmacol 2003; 58(11): 773–778 Epub 2003 Feb 21PubMedGoogle Scholar
  89. 89.
    Dormann H, Criegee-Rieck M, Neubert A, et al. Implementation of a computer-assisted monitoring system for the detection of adverse drug reactions in gastroenterology. Aliment Pharmacol Ther 2004 Feb 1; 19(3): 303–9PubMedCrossRefGoogle Scholar
  90. 90.
    Svensson M, Gustafsson F, Galatius S, et al. Hyperkalaemia and impaired renal function in patients taking spironolactone for congestive heart failure: retrospective study. BMJ 2003; 327(7424): 1141–2PubMedCrossRefGoogle Scholar
  91. 91.
    Rätz Bravo AE, Tchambaz L, Krähenbühl-Melcher A, et al. Incidence of potential drug-drug interactions in dyslipidaemic patients treated with a statin. Drug Saf 2005; 28(3): 263–75PubMedCrossRefGoogle Scholar
  92. 92.
    Schneider MP, Cotting J, Pannatier A. Evaluation of nurses’ errors associated in the preparation and administration of medication in a pediatrie intensive care unit. Pharm World Sci 1998 Aug; 20(4): 178–82PubMedCrossRefGoogle Scholar
  93. 93.
    American Society of Hospital Pharmacy. ASHP guidelines on preventing medication errors in hospitals. Am J Hosp Pharm 1993; 50(2): 305–14Google Scholar
  94. 94.
    Dean B, Schachter M, Vincent C, et al. Causes of prescribing errors in hospital inpatients: a prospective study. Lancet 2002 Apr 20; 359(9315): 1373–8PubMedCrossRefGoogle Scholar
  95. 95.
    Schneider PJ, Gift MG, Lee YP, et al. Cost of medication-related problems at a university hospital. Am J Health Syst Pharm 1995 Nov 1; 52(21): 2415–8PubMedGoogle Scholar
  96. 96.
    Wu AW, Pronovost P, Morlock L. ICU incident reporting systems. J Crit Care 2002; 17(2): 86–94PubMedCrossRefGoogle Scholar
  97. 97.
    Gurwitz JH. Polypharmacy: a new paradigm for quality drug therapy in the elderly? Arch Intern Med 2004 Oct 11; 164(18): 1957–9PubMedCrossRefGoogle Scholar
  98. 98.
    Hanlon JT, Lindblad CI, Hajjar ER, et al. Update on drug-related problems in the elderly. Am J Geriatr Pharmacother 2003; 1(1): 38–43PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  • Anita Krähenbühl-Melcher
    • 1
  • Raymond Schlienger
    • 2
  • Markus Lampert
    • 2
  • Manuel Haschke
    • 2
  • Jürgen Drewe
    • 2
  • Stephan Krähenbühl
    • 2
    Email author
  1. 1.Hospital PharmacyRegionalspital EmmentalBurgdorfSwitzerland
  2. 2.Division of Clinical Pharmacology and ToxicologyUniversity HospitalBaselSwitzerland

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