Adverse Drug Events in PharmaNet - British Columbia

This page was created with information provided by the PharmaNet ADE Project Team.

Adverse Drug Events (ADEs) are recorded and displayed in a patient's PharmaNet Profile and must be reviewed by pharmacists to determine appropriate action when dispensing prescriptions. This initiative is being implemented by the use of the ActionADE software developed by B.C. researchers to help standardize and facilitate sharing of ADE information between health care providers.

An ADE is classified as harm caused by appropriate or inappropriate use of a drug whereas adverse drug reactions are a subset of these events, where harm is directly caused by a drug under appropriate use. ADEs may include cases of provider error, non-adherence or incorrect dosages.

PharmaNet Profile in PharmaClik Rx

When viewing a patient's PharmaNet Profile in PharmaClik Rx, the patient's ADE information displays in the Clinical Condition Information and Adverse Reaction Information sections. The ADEs are identified by *ADE_HHMM, where HHMM is the timestamp when the ADE was recorded in hours (HH) and minutes (MM).

Tip: When viewing the PharmaNet Profile for ADE information, use the uncondensed view by clearing the Condense flag. This ensures you can easily cross-reference the Clinical Condition Information and the Adverse Reaction Information.

Use the dropdowns below to learn more about the ADE information displays in each section.

The following ADE information will be recorded in the Clinical Condition Information section of the PharmaNet Profile.

Table 1. Clinical Condition Information ADE Data Elements.

  Data Element Description
1 *ADE Flags that this condition is associated with an ADE and its impact to therapy should be considered.
2 Timestamp (HHMM) The timestamp of the ADE. This can be used to cross-reference the information displayed in the Clinical Condition Information and the Adverse Reaction Information sections.
3 Clinical Condition The primary symptom or condition experienced as part of the ADE.
4 Comment Detail Further details of symptoms experienced as part of the ADE.

The information in the ADE Clinical Condition is in the above order with each data element separated by an underscore.

*ADE_HHMM_Clinical Condition_Comment Detail

Table 2. Adverse Reaction Information ADE Data Elements

  Data Element Description Additional Information
1 Drug Name and DIN the drug that caused the ADE. Not applicable.
2 *ADE Flags that this condition is associated with an ADE and its impact to therapy should be considered. Not applicable.
3 Timestamp (HHMM) The timestamp of the ADE. This can be used to cross-reference the information displayed in the Clinical Condition Information and the Adverse Reaction Information sections. Not applicable.
4 Adverse Drug Event Type

Defines the type of Adverse Drug Event.

The following events can be recorded.

  • Adverse Drug Reaction
  • Allergy
  • Subtherapeutic dose
  • Suptherapeutic dose
  • Treatment failure
  • Drug Withdrawal
  • Drug Interaction
  • Non-Adherence
  • Drug Misuse
5 Certainty The level of certainty of the adverse drug event type.

The following certainty levels can be recorded.

  • Certain
  • Likely
  • Possible
  • Unlikely
  • Refusted
6 ADE Outcome The outcome of the ADE event.

The following outcomes can be recorded.

  • Death
  • Permanent disability
  • Worsen Preexist Cond
  • Fetal Defect
  • Hospitalization
  • Hospital Extended
  • Emergency Visit
  • Life Threatening
  Dose with units Included where applicable.

Not applicable.
Frequency

The information in the ADE Adverse Reaction Information is in the above order with each data element separated by an underscore.

*ADE_HHMM_Adverse Drug Event Type_Certainity_ADE Outcome_Dose_Frequency

Managing Prescriptions and ADEs

This initiative is dependent on pharmacists recording their clinical decisions in PharmaNet based on the ADE information presented to them.

When processing a prescription, the PharmaNet Drug Use Evaluation (DUE) will alert on an ADE as part of the claim process. Pharmacists should review the PharmaNet Profile for ADE information in both the Clinical Condition Information and Adverse Reaction Information sections to assess how to ADE alert should be managed clinically.

The clinical decision in response to the ADE information should be recorded as an intervention code that is submitted to the PharmaNet. To view the list of intervention codes, see ADE Intervention Codes.

Intervention codes can be entered at the time of claim adjudication due to the PharmaNet DUE alert or prior to submission of claim adjudication. See the images below to learn more about the workflow of either method.

  1. Workflow if decision is made at the time of claim adjudication and display of PharmaNet DUE alert.
  2. Workflow if decision is made prior to submission of claim adjudication.

Table 3: PharmaNet Intervention Codes for Reversal due to ADE

Code Description
RA Due to ADE alert.
RD Defer clinical decisions.
RO Override alert.

 

Table 4: PharmaNet Intervention Codes to indicate a decision to proceed with the dispense despite the ADE information

Code Description
AA Fill despite prior substance abuse.
AB Benefit outweighs risk.
AE ADE report arroneous.
AI ADE alert inappropriate.
AR ADE refuted.
AT ADE resolved/treated.

 

Table 5: PharmaNet Intervention Codes to indicate a therapeutic change as a result of ADE information

Code Description
AK ADE acknowledged and prescription changed.

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