{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T05:32:46Z","timestamp":1788067966375,"version":"build-2784847793"},"reference-count":25,"publisher":"CSIRO Publishing","issue":"6","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":1654,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pricing for safety and quality was introduced into Australian hospitals using a defined list of hospital-acquired complications (HACs). Medication-related HACs include drug-related respiratory complications (DRRC), haemorrhagic disorder due to circulating anticoagulants (HDDCA) and hypoglycaemia. The aim of this study was to determine the probability, severity and preventability of medication-related HACs, common contributory medications and themes, and whether medication-related HACs are a suitable data source to inform risk associated with medicines use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical notes were reviewed retrospectively for all patients discharged from a tertiary referral metropolitan hospital between 1 July and 31 December 2018 who were flagged as experiencing a medication-related HAC. Naranjo, Hartwig\u2019s and Schumock and Thornton tools were used to assess the probability, severity and preventability of medication-related HACs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over the 6-month period, 88 patients experienced a medication-related HAC. An HAC was not identified in five (5.7%) patient charts. The most common HAC was hypoglycaemia (n = 59; 67%), followed by HDDCA (n = 23; 26%) and DRRC (n = 6; 7%). Fifteen patients (17%) flagged with a hypoglycaemia HAC were not on a medicine associated with hypoglycaemia. Overall, 6% (n = 4) of HACs were severe, 72% (n = 49) were moderate and 22% (n = 15) were mild. Where the HAC and causal medication(s) were identified (n = 68), over half were probable (51.5%, n = 35) and 44.1% (n = 30) were possible causes of the adverse drug reaction; only two (2.9%) were definite causes. None of the DRRC HACs was preventable. Over half the HDDCA HACs (52.2%; n = 12) and almost half the hypoglycaemia HACs (46.2%; n = 18) were not preventable. Common themes included appropriate anticoagulant agent, dose and monitoring, as well as periprocedural hypoglycaemic management, which considers oral intake and comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Not all patients who experience medication-related HACs were on causative medications. Of those who were, medications were probable causal agents in over 50% of cases. Only a small number of HACs were severe and under half of medication-related HACs were preventable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What is known about the topic?<\/jats:title>\n                    <jats:p>The relationship between pricing for safety and quality and improvements in patient outcomes has shown mixed results. Medication-related harm is a problem within Australia and system-wide changes should be considered to improve patient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What does this paper add?<\/jats:title>\n                    <jats:p>This paper adds evidence to the use of medication-related HACs as a source of data to inform risk associated with medicines use and provides details on the preventability and severity of medication-related HACs and the likelihood that medicines contribute to these complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What are the implications for practitioners?<\/jats:title>\n                    <jats:p>This paper provides clinicians and policy makers details on the utility of using medication-related HACs as a measure of risk associated with medicines use. It discusses merit in using HACs as a source for quality improvement, but recommends that definitions may need to be reviewed to enhance utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/ah19215","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T01:23:18Z","timestamp":1605576198000},"page":"935-940","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of the nature, severity, likelihood and preventability of medication-related hospital-acquired complications"],"prefix":"10.1071","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6216-8728","authenticated-orcid":true,"given":"Martin","family":"Canning","sequence":"first","affiliation":[{"name":"AThe Prince Charles Hospital, Metro North Hospital and Health Service, Queensland Health, Rode Road, Chermside, Qld 4032, Australia. Email: Chui.Lee@health.qld.gov.au"},{"name":"BCorresponding author. Email: Martin.Canning@health.qld.gov.au"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chui Han","family":"Lee","sequence":"additional","affiliation":[{"name":"AThe Prince Charles Hospital, Metro North Hospital and Health Service, Queensland Health, Rode Road, Chermside, Qld 4032, Australia. Email: Chui.Lee@health.qld.gov.au"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Bolitho","sequence":"additional","affiliation":[{"name":"AThe Prince Charles Hospital, Metro North Hospital and Health Service, Queensland Health, Rode Road, Chermside, Qld 4032, Australia. Email: Chui.Lee@health.qld.gov.au"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Dunn","sequence":"additional","affiliation":[{"name":"AThe Prince Charles Hospital, Metro North Hospital and Health Service, Queensland Health, Rode Road, Chermside, Qld 4032, Australia. Email: Chui.Lee@health.qld.gov.au"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2020,11,17]]},"reference":[{"key":"2025121501003475300_R1"},{"key":"2025121501003475300_R2","unstructured":"Australia Commission on Safety and Quality in Health Care (ACSQHC). Hospital-acquired complications (HACs) list \u2013 specifications \u2013 version 2.0. Sydney: ACSQHC; 2019. 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