Lau et al reported a modification of the criteria of Schumrock and Thornton for a preventable adverse drug reaction (ADR). The following is a modification of that modification.
Criteria for a definitely preventable ADR - one or more of the following:
(1) allergic reaction with the patient having a history of allergy to the drug
(2) non-allergic reaction with the patient having a history of the reaction to the drug
(3) use of the drug inappropriate and unnecessary in the patient
(4) use of an inappropriate dose, frequency, route of administration, etc for the patient (based on age, weight, gender, race, condition, etc.)
Criteria for a probably preventable ADR - one or more of the following:
(1) failure to perform therapeutic drug monitoring or other testing that would have prevented the ADR
(2) toxic serum concentration detected
(3) associated with a known drug interaction
(4) associated with poor compliance
(5) failure to make an intervention that would have prevented the ADR
(6) administration of a preventative measure that was inadequate and/or inappropriate
where:
• Some documented drug reactions are common while others are rare. A rare association might be termed a possibly preventable ADR.
• Note that the criteria does not assign responsibility. That would come with further analysis.
• Poor compliance could apply to an interacting drug.
Other criteria that might indicate a preventable ADR:
(1) Failure to heed a finding that should have alerted the clinician to the risk of an ADR.
(2) ADR related to an error in administration (leak at infusion site, etc).
If the ADR does not meet the criteria for definitely preventable or probably preventable ADR, then it was not preventable.
