(B-154) A Qualitative Study on Iatrogenesis: Perspectives from Healthcare Professionals

Background: Iatrogenic events, resulting from medications or healthcare procedures, are a significant concern for patient safety, particularly in older populations. These events, which include adverse drug reactions and complications from medical interventions, are often underreported and can lead to severe harm.

Objectives: This study aimed to assess healthcare professionals' (HCP) perceptions of iatrogenesis, focusing on common iatrogenic events, each person’s role in prevention strategies, and the challenges faced in addressing these issues. It also explored the need for additional training and integrated support systems, especially for older patients, to prevent iatrogenic events.

Methods: A qualitative design using semi-structured interviews was employed to gather insights from HCP in hospital and primary care settings. The interview protocol was approved by the Ethics Committees of Egas Moniz Academic Clinical Centre. The interview script covered iatrogenesis concepts, prevalent events, skills for detecting events and prevention strategies, factors that increase the occurrence and challenges related to detection and implementation. Fourteen HCP participated, including physicians, pharmacists, and nurses, emphasizing older patients. Data were anonymized and analyzed thematically to identify common themes and discrepancies in responses.

Results: HCP had an understanding of iatrogenesis, recognizing both drug- and healthcare-related events. Common drug-related iatrogenic events identified by HCP included hypoglycemia, bradycardia, renal crises, and side effects, particularly in polymedicated elderly patients. Healthcare-related iatrogenesis included complications from catheterization, infections, and physical consequences of immobilization, such as confusion, dehydration, fall risk and pressure injuries. Some HCP were unaware of the WHO's ICOPE program for integrated elderly care. Training on iatrogenesis was typically limited to one-time sessions, and HCP expressed the need for more practical, ongoing training, such as workshops and online resources. Barriers to effective prevention included time constraints, resistance to change, insufficient human resources, and a lack of organizational safety culture for reporting side effects.

Conclusions: This study emphasizes HCP’s recognition of the impact of iatrogenic events, particularly for elderly patients. The findings underscore the need for more comprehensive, continuous training, improved communication, and enhanced collaboration across care levels. Integrated care programs, such as the WHO’s ICOPE initiative, along with training workshops, could address current gaps in knowledge and practice, ultimately reducing the occurrence of iatrogenic events.