Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 2;12(11):e062853.
doi: 10.1136/bmjopen-2022-062853.

Validating ICD-10 codes for adverse drug events in hospitalised older adults: protocol for a cross-sectional study

Mitchell Nohner  1 , Bryanna De Lima  1 , Katie Drago  2
Affiliations

Validating ICD-10 codes for adverse drug events in hospitalised older adults: protocol for a cross-sectional study

Mitchell Nohner et al. BMJ Open. .

Abstract

Introduction: Adverse drug events (ADEs) among hospitalised older adults are common yet often preventable. Efforts to recognise ADEs using pharmacist review and electronic health record adaptations have had mixed results. Our health system developed and implemented a geriatric prescribing context designed to offer age-friendly dose and frequency defaults for hospitalised patients 75 years and older. The impact of this context on ADEs remains unknown. To measure its impact, our team created a list of ADE-related International Classification of Diseases (ICD) codes specific to 10 commonly used medications at our institution. This protocol paper presents the process of designing a screening tool for ADEs, validating the tool with manual chart reviews and measuring the impact of the context on ADEs.

Methods and analysis: This retrospective cross-sectional study will assess our list of ICD-10 codes against manual chart review to determine its accuracy. An electronic health record report for patients aged 75 years and older admitted to the hospital for a minimum of two nights was generated to identify 100 test positives and 100 test negatives. Test positives need at least one code from each level of our ICD-10 code list. The first level of codes identifies any possible ADEs while the second level is more symptom based. Test negatives must not have any code from the list. Two physicians blinded to test status will complete a structured chart review to determine if a patient had an ADE during their hospitalisation. Acceptable inter-rater reliability will need to be met before proceeding with independent chart review. Positive predictive value and negative predictive value will be calculated once all the chart reviews are completed.

Ethics and dissemination: The Oregon Health & Science University Institutional Review Board approved this study (#21385). The results of the study will be disseminated in peer-reviewed journals and conference presentations.

Keywords: Adverse events; GERIATRIC MEDICINE; Quality in health care.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

    1. Davies EC, Green CF, Taylor S, et al. . Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes. PLoS One 2009;4:e4439. 10.1371/journal.pone.0004439 - DOI - PMC - PubMed
    1. Jennings ELM, Murphy KD, Gallagher P, et al. . In-Hospital adverse drug reactions in older adults; prevalence, presentation and associated drugs-a systematic review and meta-analysis. Age Ageing 2020;49:948–58. 10.1093/ageing/afaa188 - DOI - PubMed
    1. McDonald EG, PE W, Rashidi B. The MedSafer Study—Electronic decision support for deprescribing in hospitalized older adults: a cluster randomized clinical trial. JAMA Intern Med 2022. 10.1001/jamainternmed.2021.7429 - DOI - PMC - PubMed
    1. Abraham J, Kitsiou S, Meng A, et al. . Effects of CPOE-based medication ordering on outcomes: an overview of systematic reviews. BMJ Qual Saf 2020;29:1.7–2. 10.1136/bmjqs-2019-010436 - DOI - PubMed
    1. Roumeliotis N, Sniderman J, Adams-Webber T, et al. . Effect of electronic prescribing strategies on medication error and harm in hospital: a systematic review and meta-analysis. J Gen Intern Med 2019;34:2210–23. 10.1007/s11606-019-05236-8 - DOI - PMC - PubMed

MeSH terms