Iatrogenic
As iatrogenic ( ancient Greek ἰατρός iatros , German , doctor ' and γένεσις genesis , German , origin' , ie, produced by the doctor ') syndromes are referred to, which were caused by medical intervention or worse, regardless of whether they are according to the state of medical science were avoidable or unavoidable. In a broader sense, every other effect of medical action, especially healing, is iatrogenic.
Iatrogenic diseases include, for example, iatrogenic infections as well as undesirable side effects of medications administered by a doctor. A typical example of an iatrogenic complication is the iatrogenic pneumothorax when a vascular catheter is inserted into the subclavian vein . Incorrect medication prescription is also an important complication caused by medical action.
This term is also used with the same meaning in psychology ( psychological diagnostics , psychological assessment) when diagnostics, diagnoses or assessments contribute to the development or intensification of mental disorders or impairments of well-being solely through the type of mediation ( iatrogenic noxa ).
A problem area of great health policy implications is the iatrogenic drug dependency, especially of psychotropic drugs (the so-called low-dose dependency ).
Frequency of iatrogenic complications
A 2009 UK General Medical Council study looked at 124,260 prescriptions over a week in 19 different hospitals in the north-west of England. 11,077 of the regulations contained errors, which corresponds to a rate of 8.9%. 1.7% of these errors were potentially fatal. Almost all errors were discovered by other staff before the medication was administered to the patient. The percentage differences in the error rate when taking into account the level of training were small. The authors made some suggestions for improvement such as changes in the clinical environment, in the training of medical professionals as well as a standardization of the medicament sheet and the establishment of an "error culture". A current study on the situation in Germany does not exist.
According to a report in Stern , nursing staff is responsible for only a third of all errors that occur when prescribing medication . Mix-ups played a role here, for example. In two thirds of the cases, it is the doctors, for example due to failure to observe contraindications or negative interactions. According to the article, according to Frölich's calculations, 57,000 people die every year in wards of internal medicine as a result of drugs. Of these, 28,000 deaths are avoidable.
Individual evidence
- ^ B. Glier: Drug abuse and dependence in chronic pain disorders: development, diagnosis and therapy . In: H.-D. Basler, C. Franz, B. Kröner-Herwig (eds.): Psychological pain therapy - basics, diagnostics, clinical pictures, treatment . 3. Edition. Springer, Heidelberg, p. 694 .
- ↑ How to reduce prescribing errors. In: The Lancet . Vol. 374, No. 9706, December 2009, p. 1945, doi: 10.1016 / S0140-6736 (09) 62104-8 .
- ↑ a b hospital crisis area. In: Stern . No. 36, 2010, p. 34 ff.