Beyond Substance Abuse: Drug Safety Becoming a Major Health Concern


According to, the Human Drugs Program monitors over 10,000 currently marketed drugs in the U.S.  According to the Centers for Disease Control (CDC), prescription drug spend in 2008 doubled from the previous decade as 10% of Americans now use five or more prescription drugs.

It’s not controversial to assert that drug information, education and compliance is a huge, complex and important issue confronting the healthcare landscape.

Given this complexity, it has become exceedingly difficult for physicians to track potential adverse reactions to drugs and maintain appropriate antibiotic prescriptions, particularly when they are diagnosing or administering care at the patient bedside.

Below is some backdrop and perspective on why TripleTree is following this so closely:

  • The FDA currently tracks adverse drug events through a post-marketing surveillance program, compiling the results in their adverse event reporting system (AERS). While this is helpful to identify black box warnings, it is not designed to help the physician stay up to speed with new medical knowledge.
  • The issues surrounding the use of prescription drugs are most severe in the hospital setting where patients are vulnerable to unforeseen interactions or medical errors that take place during the medication use process.
  1. Many hospitals today are fighting these challenges pre and post-event, using clinical informatics tools that focus on reducing errors in prescribing or retroactively treating patients who have experienced an adverse event.
  2. Unfortunately most events take place during the “monitoring stage” of the medication use process, when the adverse effects are most difficult to catch. For an outline of the five stages of the medication use process, see U.S. Pharmacopeia.
  • Few hospitals have a system in place to monitor drug use during the patients’ stay.  According to a study conducted at the University of California, only one third of CA hospitals are using tech-enabled surveillance tools to help identify infections and those that did saw significant improvements in infection control practices and patient outcomes.
  • Appropriate antibiotic use, known as antimicrobial stewardship, has been in the spotlight lately as the failure of antibiotics to effectively treat certain strains of bacteria becomes a more acute concern. Even with the constant influx of new drugs, many modern antibiotics have been so heavily (and often inappropriately) used that bacteria have developed resistance and rendered them ineffective.

For physicians who are not accustomed to employing clinical data and evidence-based guidelines for real-time decision making at the point of care, a change to incorporate drug safety at the point of care could been seen as a disruption to their workflow and very costly. However, the ramifications for ignoring adverse drug events (and increasing patient deaths) in the face of reform are equally concerning.

While the American Recovery and Reinvestment Act is oriented around the interoperability of healthcare data, significant hurdles exist to stimulate provider adoption.   TripleTree is paying close attention to the innovative vendors who offer clinical informatics technologies, decision support tools and patient surveillance systems.  These tools are bending the cost curves, and patient safety concerns, of drug safety enough to encourage physicians to adopt point of care solutions and will play a key role as health reform evolves.

We’d be interested to know what you think – have a great week!

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