CIHR Foundation Grant: When Treatments Harm: Building Better Systems and Enhancing Research Capacity to Reduce Adverse Drug Events

Principle Investigator: Corinne Michele Hohl.

Ellen Balka serves as Co-Investigator on this project.

Medications have transformed the lives of Canadians who suffer from painful or debilitating illnesses. However, medications may also cause harm. As medication use rises, so does the incidence of adverse drug events-harmful and unintended events related to medication use. Today, adverse drug events cause 1.7M annual emergency department visits in Canada, and are a leading cause of hospital admissions. Identifying and treating patients with adverse drug events is not easy. Healthcare providers often unknowingly re-expose patients to medications that previously caused harm. This is because we misdiagnose 40% of adverse drug events, and lack effective ways of communicating information about these events between care providers even after the diagnosis is made. For example: "I saw a diabetic who was discharged from hospital recently, where he was admitted for hypoglycemia [low blood sugar] due to glyburide [a blood sugar lowering drug]. The physician asked him to stop the glyburide, and gave him a prescription for gliclazide, a drug with a lower risk of causing hypoglycemia. But the patient presented here comatose with an even lower blood sugar. When I looked at the patient's blister pack I discovered that both glyburide and gliclazide had been dispensed. The patient had been given a discharge prescription for gliclazide, but no note was made to discontinue glyburide, and neither the GP [general practitioner] nor the community pharmacist were aware of what had happened." Hospital pharmacist, 2012. To address this gap, I aim to develop, evaluate and implement innovative solutions to help healthcare providers diagnose and treat patients with adverse drug events, and prevent harmful re-exposure. My team plans to create the first adverse drug event surveillance program in Canada, improve the quality of data on adverse drug event outcomes, and create a new resource for health professionals to study safer prescribing, optimize medication use and improve health outcomes.