Preventing Harm with the Use of Opioids, Anticoagulants and Insulin

The Hospital and Healthsystem Association of Pennsylvania’s work on Adverse Drug Events (ADE) provides tools and support, and facilitates collaboration to help facilities reduce harm associated with opioids, anticoagulants, and insulin. 

Adverse Drug Events

Business Case:  According to the U.S. Department of Health and Human Services, an Adverse Drug Event (ADE) is an injury resulting from medical intervention related to a drug. This includes medication errors, adverse drug reactions, allergic reactions, and overdoses.

ADEs can happen anywhere: in hospitals, long-term care settings, and outpatient settings.

In inpatient settings, ADEs:

  • Account for an estimated 1 in 3 of all hospital adverse events
  • Affect about 2 million hospital stays each year
  • Prolong hospital stays by 1.7 to 4.6 days

Each year, ADEs in outpatient settings account for:

  • More then 3.5 million physician office visits
  • An estimated 1 million emergency department visits
  • Approximately 125,000 hospital admissions

The most common cause for patients 65 years of age and older to visit emergency departments were in three medication classes:

  • Oral anticoagulants or antiplatelet agents
  • Antidiabetic agents
  • Narrow therapeutic index agents

Together, these three medication classes caused nearly half of all emergency department visits for ADEs but were prescribed in only 9.4 percent of outpatient visits.

The good news is that most ADE’s are preventable. The Hospital and Healthsystem Association of Pennsylvania provides tools and supports, and facilitates collaboration to help facilities reduce harm associated with opioids, anticoagulants, and insulin.

Through its Opioid Learning Action Network (LAN), HAP supports Pennsylvania’s hospitals in working collectively to identify, create, and disseminate promising practices to measurably increase the number of patients entering evidence-based treatment for opioid use disorder (OUD) and reduce overdose deaths.

HAP Contacts

For more information, contact Beth Murray. Media inquiries should be directed to Chris Daley, HAP's vice president, strategic communications.

HAP News

Lessons from HAP’s Opioid LAN: Understanding the Nuances in Opioid Use Disorder Care

HAP’s Opioid Learning Action Network (LAN) brings together providers from across the commonwealth to address the opioid crisis in Pennsylvania.

As the COVID-19 pandemic enters its second year, the nation’s health care community continues to raise concerns about a parallel public health crisis in behavioral health, including a nearly 30 percent increase in overdose deaths from October 2019 through September 2020 when compared with the previous 12-month period.

Last week, members of HAP’s Opioid LAN convened to discuss the nuances in diagnosing patients with opioid use disorder and the challenges of understanding drug screening. The event featured a presentation by Lee Radosh, MD, FAAFP, FASAM, Addiction Medicine—Tower Health Medical Group, and medical director of Reading Hospital’s Center of Excellence for Opioid Use Disorder.

Among the key takeaways from the discussion:

  • ‘What does (this substance) do for you?’:  Starting a conversation with patients about why they use a particular substance provides clinicians with critical information to understand the underlying causes for drug use and helps guide care
  • Opioid use disorder vs. physiologic dependence:  It can be difficult to identify the difference between dependence and opioid use disorder. Providers can make a difference by identifying overall patient problems and behaviors
  • Language matters:  Tests come back positive or negative for specific substances. They may also have “expected” or “unexpected” results based on a patient’s treatment regimen. Terms such as “hot, dirty, or clean” can contribute to the stigma surrounding patient care and should be avoided
  • Drug testing is not black and white:  Context matters and initial screening results need to be carefully evaluated and understood. An unexpected drug screen is the start—not the end—of a conversation between providers and patients
  • Getting the full picture:  Different tests are able to detect the presence of different substances. Rapid and confirmatory tests can yield different results. Providers need to be cognizant of the way a patient’s medication profile can impact screening results. Misunderstood drug tests cause barriers to care

A recording of the presentation is available online.

HAP and Pennsylvania’s health care community continue to work together to address the opioid crisis. Tomorrow, HAP’s Opioid LAN is hosting a discussion about the Management of Opioid Use Disorder in Primary Care Using Research-Based Evidence.

In its second year, HAP’s Opioid LAN is focused on increasing access to evidence-based substance use disorder care across an array of clinical entry points and community providers.

For more information about HAP’s Opioid LAN, contact Jennifer Jordan, HAP’s vice president, regulatory advocacy, or Daneen Schroder, HAP’s vice president, business development and member services.