NCC MERP’s new tool will assist in preventing medication-related harm

Tool is based on an ADE algorithm

The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) has developed a tool to assist practitioners, including pharmacists, in minimizing exposure to medication-related harm.

The tool, which is based on an adverse drug event (ADE) algorithm, will help practitioners understand different types of medication-related events and determine if they are preventable or not. To accomplish this, NCC MERP, which has frequently been asked to clarify terms related to medication errors, proposed new terminology for practitioners to determine the difference among ADEs, adverse drug reactions (ADRs), which are a subset of ADEs, and medication errors.

For example, the terms ADE and ADR have previously been used inconsistently when a drug has caused patient harm. By definition, an ADR is harm that results from a medication dose that is “normally used in man,” and an ADE has been defined as harm associated with any dose of a drug whether “normally used in man” or not. Therefore all ADRs can be ADEs but not vice versa—one of many points of potential confusion.

The tool also identifies decision points for determining whether an ADE is preventable. ADEs are among the most common causes of health care-related harm, according to the U.S. Department of Health & Human Services’ National Action Plan for Adverse Drug Event Prevention.

By coming up with better definitions of the terminology and establishing clearer relationships between the terms, NCC MERP is working to stimulate consistent adoption across all areas of health care.

With the help of practitioners and researchers in the medication safety community, NCC MERP hopes the algorithm and its associated case scenarios will be used to develop methods to identify ADEs and to clarify the differences among ADEs, ADRs, and medication errors.

For more information about NCC MERP and its work to improve medication safety, please visit: www.nccmerp.org.