Epidemiology of Adverse Drug Events and Medication Errors in Nursing Homes in Japan: THE Japan Adverse Drug Events (JADE) study

2020 Fiscal Year Final Research Report

• Project/Area Number: 17K15833
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Epidemiology and preventive medicine
• Research Institution: Kyoto Prefectural University of Medicine
• Principal Investigator: Ayani Nobutaka 京都府立医科大学, 医学(系)研究科(研究院), 客員講師 (90777939)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: 薬剤性有害事象 / 薬剤関連エラー / 高齢者介護施設 / 医療安全

Outline of Final Research Achievements

This prospective cohort study was conducted at 4 nursing homes for older people in Japan. Based on the validated methodology (Morimoto, 2004), trained psychologists, psychiatrists and internists reviewed all charts to identify suspected Adverse Drug Events (ADEs) and Medication Errors (MEs). We enrolled 459 residents which yielded 3315 resident-months of observation time. We identified 1207 ADEs and 600 MEs (incidence: 36.4 and 18.1 per 100 resident-months, respectively) during the study period. Fall (40%) was the most frequent symptoms of ADEs and the most common class of drugs associated with ADEs was atypical antipsychotics (16%). Among the severity, fatal, life-threatening and serious ADEs accounted for 0.8%, 2.3 % and 12 % of all events, respectively. Medication errors were most frequently seen in monitoring stage (72 %). The incidence of ADEs and MEs were about 3-4 times higher than those in long-term care facilities in U.S (Gurwitz, 2005).

Free Research Field

医療安全

Academic Significance and Societal Importance of the Research Achievements

日本の高齢者介護施設における薬剤性有害事象（ADE）および薬剤関連エラー（ME）を確立された方法論により初めて明らかにした。ADEおよびMEの発生率は、米国の長期介護施設における発生率の約3～4倍で、日本の一般病院における発生率とほぼ同じであり(Morimoto, 2011)、これは日本の介護施設における薬剤処方量の多さが関係している可能性がある。今回の調査結果から、介護者は入居者の転倒や排泄の問題に注意を払い、また投薬においては投薬後の観察段階に焦点を当てることで、薬剤使用に伴う問題の抑制につながる可能性を示したことで、今後の介護施設における安全な薬剤使用に寄与するという点で意義がある。