Adverse Drug Events and Contributing Factors Among Hospitalized Adult Patients at Jimma Medical Center, Southwest Ethiopia: A Prospective Observational Study

Abstract

Background Adverse drug events (ADEs) are common complications of clinical care resulting in significant morbidity, mortality, and high clinical expenditure. Population-level estimates of inpatient ADEs are limited in Ethiopia. Objective This study aimed to assess the incidence, contributing factors, severity, and preventability of ADEs among hospitalized adult patients at Jimma Medical Center, Ethiopia. Methods A prospective observational study design was conducted among hospitalized adult patients at tertiary hospital in Ethiopia. A structured data collection tool was prepared from relevant literatures for data collection. Data were analyzed using statistical software. Logistic regression was performed to identify factors contributing to ADE occurrence. P values < 0.05 were considered statistically significant. Results A total of 319 patients were included with follow-up period of 5667 person-days. About 50.5% were women. The mean (SD) age of patients was 43 (17.6) years. One hundred sixteen ADEs were identified with the incidence of 36.4 (95% CI, 30.1–43.6) per 100 admissions and 20.5 (95% CI, 16.9–24.6) per 1000 person-days. Antituberculosis agents (adjusted odds ratio [aOR] = 2.52; 95% CI, 1.06–5.98; P = 0.036), disease of the circulatory system (aOR = 2.67; 95% CI, 1.46–4.89; P = 0.001), disease of the digestive system (aOR = 2.84; 95% CI, 1.45–5.57; P = 0.002), being on medication during admission (aOR = 3.09; 95% CI, 1.77–5.41; P < 0.001), and hospital stay more than 2 weeks (aOR = 3.93; 95% CI, 1.39–11.12; P = 0.010) were independent predictors of ADE occurrence. Conclusions One in every 4 patients admitted to the hospital experienced ADEs during their hospital stay. Most ADEs were moderate in severity. About two-thirds of the ADEs identified were deemed probably or definitely preventable. Therefore, it is high time to reinforce large-scale efforts to redesign safer, higher quality health care systems to adequately tackle the problem.

Incidence of adverse drug events in patients hospitalized in the medical wards of a teaching referral hospital in Ethiopia: a prospective observational study

“…A Prospective study by Davies E from the UK showed that approximately three-quarters of ADRs were scored at level 3 or below on the Hartwig scale [ 5 ]. Similarly, a study conducted in Ethiopia also agrees with our result, in which, 52.6% were moderate, and 37.1% were mild [ 15 ]. Contrary to the present study, in a multicenter, retrospective cohort study from Massachusetts, United States of America, about half of ADEs were rated as severe (serious in 49.4% and life-threatening in 11.7%) [ 46 ].…”

“…A Prospective analysis from the UK reported that the median length of stay for patient episodes that resulted in an ADEs was 20 days, compared to 8 days ( p < 0.0001) for those episodes without ADEs [ 5 ]. Prospective observational studies in children and adults in Ethiopia revealed that patients with a prolonged length of stay were more associated with the occurrence of ADEs [ 15 , 50 ]. This could be explained as patients with longer LOHS suffer from more severe conditions, multiple comorbid diseases, and had a higher dose of different drugs.…”

“…Sample size (n) was calculated using a single population proportion formula considering the proportion of ADE occurrence (P) of 0.36 [ 15 ]; level of confidence (Z = 1.96) of 95%; the size of patients admitted in the previous 6 months before this study (N) =640; and margin of error (W) of 5%. The final sample size was 240.…”

“…Globally, ADEs are among the major public health concerns with variable incidence reports across the studies. For instance, a study from Japan reported 29.2% [ 12 ], a study from Saudi-Arabia revealed 8.5% [ 13 ], in Africa, studies from Uganda recorded 25% [ 14 ], while a study from Ethiopia reported 36.4% [ 15 ] ADE incidences. These variable reports are attributed to factors such as differences in the strategies employed for detecting ADEs [ 9 , 10 ], the specific study definition of ADEs, and others.…”

“…In a cross-sectional study on adverse drug reaction-related hospitalization from Jimma University medical centre, adverse drug reactions accounted for 10.3% of hospital admissions [ 38 ]. Another study from the same setting found that above quarter of patients (26.6%) admitted to the hospital experienced ADEs during their hospital stay [ 15 ]. Because of the scarce availability of such studies in Ethiopia, this study was proposed and conducted to assess the incidences and determinants of ADE among patients hospitalized in the medical wards.…”