{"id":26245,"date":"2026-06-24T17:33:33","date_gmt":"2026-06-24T15:33:33","guid":{"rendered":"https:\/\/www.smith.care\/?p=26245"},"modified":"2026-06-24T17:41:47","modified_gmt":"2026-06-24T15:41:47","slug":"results-polar-part-2","status":"publish","type":"post","link":"https:\/\/www.smith.care\/en\/2026\/06\/24\/results-polar-part-2\/","title":{"rendered":"Detection and Prediction of Adverse Drug Events: Results from the POLAR Project \u2013 Part 2"},"content":{"rendered":"\n

Clinical Pharmacist Dr. Anna Wermund in Interview<\/strong><\/p>\n\n\n\n

Medications are among the most common therapeutic interventions in patient care.<\/em><\/p>\n\n\n\n

At the same time, adverse drug events (ADEs) can lead to complications and, in the worst case, even result in hospital readmissions. Older adults are particularly affected, as they often take multiple medications simultaneously. In this group, the risk of drug interactions and side effects increases considerably. Within POLAR, a use case of the German Medical Informatics Initiative (MII)<\/a>, researchers investigated, among other topics, the relationship between polypharmacy and health risks. In this two-part series, we present key findings from the POLAR studies.<\/em><\/p>\n\n\n\n

In the second part, Dr. Anna Wermund shares insights into the valuable findings for medication safety research that emerged from her subprojects within POLAR. From 2020 to 2025, she worked as a research associate in POLAR and INTERPOLAR and now heads the Research and Development Department for the MediCheck\u00ae product at the software company pharma4u GmbH. Her work in POLAR focused on identifying ADEs in routine clinical data from different university hospitals. In this interview, Dr. Anna Wermund explains the challenges she encountered, how these were addressed, and how she assesses the current state of medication safety research.<\/em><\/p>\n\n\n\n

What do you find particularly exciting and important about medication safety?<\/strong><\/p>\n\n\n\n

I often repeat a quote that I used in my dissertation defense: \u201cHouston, we have a problem.\u201d Despite various efforts, far too many patients still suffer harm from medication errors or preventable ADEs, even in 2026. Medication safety is therefore not only an incredibly exciting field but also an incredibly important one if we want to achieve meaningful improvements. Medication safety means making healthcare processes safer before harm occurs. The digital age enables us to establish new processes that improve medication safety and to use ever-growing amounts of data to better understand the causes of medication errors and ADEs. Because these causes are complex, medication safety research requires interprofessional collaboration. Pharmacists can play an important role in this area.<\/p>\n\n\n\n

What exactly did you investigate in the POLAR study?<\/strong><\/p>\n\n\n\n

In the POLAR study, we investigated how ADEs can be identified in routine data from hospitalized patients and, as a next step, how they can be prevented. We also examined the potential of German routine healthcare data and tested the feasibility of a distributed analysis approach. In a distributed analysis, data from several hospitals are analyzed while remaining at the respective institutions. Analysis scripts are sent to each site and executed locally. The individual results are then combined into an overall result through a so-called meta-analysis.

In another subproject, we conducted an expert survey using the RAND\u00ae\/UCLA Appropriateness Method to develop drug-event pairs as indicators of ADEs in routine data.<\/p>\n\n\n\n

What challenges did you overcome during the project?<\/strong><\/p>\n\n\n\n

Key challenges included data quality, the heterogeneity of multicenter routine data, and establishing a shared understanding among the different professional groups involved. Many Data Integration Centers were still under development at the beginning of the project. As a result, there were missing values, heterogeneous datasets, and imprecise timestamps.

We also learned that interoperability is not the same as data harmonization. Despite the use of common standards such as HL7\u00ae FHIR\u00ae, differences in data practices remained\u2014for example, in laboratory value units or diagnostic data. Without consulting the individual centers, it was often unclear how certain data should be interpreted.
We therefore took a step-by-step approach. We first assessed the data and then conducted analyses of increasing complexity. This allowed us to describe existing challenges and uncertainties while still drawing valid conclusions.<\/p>\n\n\n\n

What were the key findings of your project?<\/strong><\/p>\n\n\n\n

As part of the expert survey, 255 drug-event pairs (for example, hyperkalemia and ACE inhibitors) were evaluated. Of these, two were classified as indicators of definite ADEs, 42 as indicators of probable ADEs, 137 as indicators of possible ADEs, and 74 as indicators of unlikely ADEs. Indicators of possible, probable, and definite ADEs can now be used specifically in future research projects, for example to measure the prevalence of ADEs. Through our distributed analysis approach, we demonstrated that cross-site analyses of routine healthcare data in Germany are fundamentally feasible. At the same time, we helped raise awareness of what distributed analyses require\u2014for example, clearly defined standard values.

In addition, we contributed to improving interoperability and data quality at the Data Integration Centers. In one analysis, for instance, every patient at a particular site appeared to have elevated hemoglobin levels because a unit had been entered incorrectly. Errors like this can now be identified and avoided more effectively in future projects.
Overall, POLAR has made an important contribution to the further development of the Medical Informatics Initiative and to the use of routine healthcare data for ADE research.<\/p>\n\n\n\n

How have medication safety and the IT landscape changed since the start of the study?<\/strong><\/p>\n\n\n\n

Data quality has improved continuously, as the Data Integration Centers were still being established when the study began. They have now been operational for several years, primary systems have improved, and healthcare professionals have gained more experience working with electronic health records. As a result, data entry quality is likely to have improved as well. With version 2.0 of the MII Core Data Set, FHIR profiles are now available that document which medications were prescribed in the hospital and which medications patients were taking beforehand. This will significantly advance causality analyses in medication safety research.

Another positive development is the much more consistent use of UCUM, the system for standardized coding of measurement units. In addition, hospitals are increasingly introducing unit-dose systems, which enable more complete documentation of medication administration and therefore provide more reliable data on drug therapies.<\/p>\n\n\n\n

What would you do differently today?<\/strong><\/p>\n\n\n\n

I would communicate even more from the very beginning and assess data availability in advance by asking all participating sites how many observations are available for each variable. Variables with a high proportion of missing values would initially be excluded from the analysis. At the same time, I would investigate missing data more thoroughly. In addition to creating an analysis plan for examining patterns of missing data, I would generate a population description for cases without missing values and include missing values as separate variables in regression analyses. There are very interesting methods for exploring how informative missing data can be.<\/p>\n\n\n\n

What are your personal next research goals?<\/strong><\/p>\n\n\n\n

For me, one thing is clear: science only unfolds its true value when it is applied. Since research without practical implementation remains purely theoretical, my current position at pharma4u GmbH focuses on translating scientific findings into digital, practice-oriented solutions. My goal is to demonstrate the significant contribution pharmacists can make to improving medication safety\u2014and that contribution is substantial.
In the context of electronic patient records and the new models of care they enable, I would like to evaluate what a sustainable, cross-sector medication management process could look like in outpatient care and at the interface between outpatient and hospital settings.
<\/p>\n\n\n\n

You can find more information about the results from the POLAR subprojects in the following publications:<\/strong><\/em><\/p>\n\n\n\n

Wermund AM, Haerdtlein A, Fehrmann W, Weglage C, Dreischulte T, Jaehde U. Drug-Event Pairs as Indicators for the Detection of Adverse Drug Reactions during Hospitalization in Routinely Collected Electronic Data Sources. Clin Pharmacol Ther. 2025 Jun;117(6):1811-1819. doi: 10.1002\/cpt.3635<\/a>. Epub 2025 Mar 18. PMID: 40099752; PMCID: PMC12087692.<\/p>\n\n\n\n

Wermund AM, Thalheim T, Medek A, Schmidt F, Peschel T, Str\u00fcbing A, Neumann D, Scherag A, Loeffler M, Kesselmeier M, Jaehde U; POLAR_MI Consortium. Challenges in detecting and predicting adverse drug events via distributed analysis of electronic health record data from German university hospitals. PLOS Digit Health. 2025 Jun 26;4(6):e0000892. doi: 10.1371\/journal.pdig.0000892.<\/a> PMID: 40569944; PMCID: PMC12200832.<\/p>\n\n\n\n


Part One of our series: Increased Risk of Falls Due to Potentially Inappropriate Medication (PIM)? What the Data from the POLAR Project Show<\/a><\/p>\n\n\n\n

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