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Monitoring of adverse drug events in hospitals.

The article appearing in this issue of JAMA by Classen et al, 1 "Computerized Surveillance of Adverse Drug Events in Hospital Patients," emphasizes the importance of adverse drug event (ADE) monitoring in hospitals. The authors' automated system includes rapid computerized identification of potential ADEs, with evaluation by a clinical pharmacist, and is coupled with enhanced hospital staff reporting. Over the 18-month study period, ADE detection and reporting increased 60-fold. The distinctive feature of this program is rapid communication with those providing the patient's medical care. The authors report that "over 75% of verified ADEs in this study did not have the causative agent stopped until study personnel informed the physician of the ongoing ADE." 1 As recognized by the Food and Drug Administration (FDA), the Joint Commission on Accreditation of Healthcare Organizations, and others, 2-4 active hospital surveillance of drug use and resultant ADEs serves many purposes,