Pharmacoepidemiol Risk Manage.  2023 Sep;15(2):157-164. 10.56142/perm.23.0015.

Nationwide Use of High-Alert Medications

• Jeong J
• Lee S
• Lee AY
• Heo KN
• Park S
• Chae H
• Lee JY
• Min Si
• Ah YM
• Han JM

• KMID: 2551232
• DOI: http://doi.org/10.56142/perm.23.0015

Abstract

Objective
This study aimed to estimate the rate of high-alert medication (HAM) use in nationwide representative claims data and compare the rates by types of healthcare settings.
Methods
This cross-sectional study used data obtained from 2019 and 2020 Health Insurance Review and Assessment Service National Patient Sample (HIRA-NPS) and National Inpatient Sample (HIRA-NIS). The study focused on essential HAMs from the HAM list for acute, long-term, and primary care settings. The usage was quantified in terms of the number of patients receiving the medications at least once, the proportion within the entire patient population, and the ratio of prescription days for HAMs to total days. We also analyzed the rate of inpatients who received HAMs in HIRA-NIS.
Results
Among 1,888,831 patients included in the database, 480,852 patients (25.5%) received HAMs at least once annually, with oral benzodiazepine derivatives being the most commonly prescribed. Substantial variations were observed in HAM usage across healthcare settings with the highest prevalence observed in long-term care hospitals (32.4%) followed by acute care hospitals (24.8%) and primary care clinics (15.3%). Among inpatient populations, injectable benzodiazepines, anesthetics, and neuromuscular blockers were frequently prescribed.
Conclusion
This study offers insights into the utilization of HAMs across various healthcare settings. It highlights the need for targeted interventions and management strategies to ensure the safe use of these medications, particularly in long-term care settings.

Keyword

High-alert medication; Prescription drugs; Patient safety; Benzo diazepines