Clinical coding of prospectively identified paediatric adverse drug reactions--a retrospective review of patient records

BMC Pharmacol Toxicol. 2014 Dec 17;15:72. doi: 10.1186/2050-6511-15-72.

Abstract

Background: National Health Service (NHS) hospitals in the UK use a system of coding for patient episodes. The coding system used is the International Classification of Disease (ICD-10). There are ICD-10 codes which may be associated with adverse drug reactions (ADRs) and there is a possibility of using these codes for ADR surveillance. This study aimed to determine whether ADRs prospectively identified in children admitted to a paediatric hospital were coded appropriately using ICD-10.

Methods: The electronic admission abstract for each patient with at least one ADR was reviewed. A record was made of whether the ADR(s) had been coded using ICD-10.

Results: Of 241 ADRs, 76 (31.5%) were coded using at least one ICD-10 ADR code. Of the oncology ADRs, 70/115 (61%) were coded using an ICD-10 ADR code compared with 6/126 (4.8%) non-oncology ADRs (difference in proportions 56%, 95% CI 46.2% to 65.8%; p < 0.001).

Conclusions: The majority of ADRs detected in a prospective study at a paediatric centre would not have been identified if the study had relied on ICD-10 codes as a single means of detection. Data derived from administrative healthcare databases are not reliable for identifying ADRs by themselves, but may complement other methods of detection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Clinical Coding / statistics & numerical data*
  • Drug-Related Side Effects and Adverse Reactions / diagnosis*
  • Hospitalization / statistics & numerical data
  • Hospitals, Pediatric / statistics & numerical data*
  • Humans
  • International Classification of Diseases*
  • Retrospective Studies
  • Tertiary Care Centers / statistics & numerical data*