Adverse drug reactions related to hospital admission in Slovak elderly patients

Wawruch, Martin; Zikavska, Martina; Wsólová, Ladislava; Kuželová, M; Kahayova, Katarina; Strateny, Kamil; Kristová, Viera

doi:10.1016/j.archger.2008.01.004

Cited by 31 publications

(41 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Seven additional studies also described initial clinician determination of DRVs, but did not report additional independent case adjudication [18], [19], [26], [27], [36], [37], [40]. Ten studies did not provide information about who identified the DRVs [20], [22], [23], [28], [31], [35], [38], [39], [46], [47].…”

Section: Resultsmentioning

confidence: 99%

Drug-Related Hospital Visits and Admissions Associated with Laboratory or Physiologic Abnormalities—A Systematic-Review

2013

View full text Add to dashboard Cite

Countless studies have demonstrated that many emergency-room visits and hospital admissions are drug-related and that a significant proportion of these drug-related visits (DRVs) are preventable. It has not been previously studied which DRVs could be prevented through enhanced monitoring of therapy. The objective of the study was to determine the incidence of DRVs attributed to laboratory or physiologic abnormalities. Three authors independently performed comprehensive searches in relevant health care databases using pre-determined search terms. Articles discussing DRV associated with poisoning, substance abuse, or studied among existing in-patient populations were excluded. Study country, year, sample, design, duration, DRV identification method, proportion of DRVs associated with laboratory or physiologic abnormalities and associated medications were extracted. The three authors independently assessed selected relevant articles according to the Strengthening the reporting of observational studies in epidemiology (STROBE) as applicable according to the studies' methodology. The initial literature search yielded a total of 1,524 articles of which 30 articles meeting inclusion criteria and reporting sufficient laboratory or physiologic data were included in the overall analysis. Half employed prospective methodologies, which included both chart review and patient interview; however, the overwhelming majority of identified studies assessed only adverse drug reactions (ADRs) as a drug-related cause for DRV. The mean (range) prevalence of DRVs found in all studies was 15.4% (0.44%–66.7%) of which an association with laboratory or physiologic abnormalities could be attributed to a mean (range) of 29.4% (4.3%–78.1%) of cases. Most laboratory-associated DRVs could be linked to immunosuppressant, antineoplastic, anticoagulant and diabetes therapy, while physiologic-associated DRVs were attributed to cardiovascular therapies and NSAIDs. Significant proportions of laboratory and physiologic abnormalities contribute to DRVs and are consistently linked to specific drugs. These therapies are potential targets for enhanced medication monitoring initiatives to proactively avert potential DRVs.

show abstract

Section: Resultsmentioning

confidence: 99%

Drug-Related Hospital Visits and Admissions Associated with Laboratory or Physiologic Abnormalities—A Systematic-Review

2013

View full text Add to dashboard Cite

show abstract

“…Drugs were classified using the WHO Anatomical Therapeutic Chemical Classification (ATC) System . Calculation of the number of medications was based on the number of active ingredients in single and combination products . Drug interactions were checked using the Micromedex‐2 software followed by clinical judgement, and the severity levels were classified as contraindicated (avoid combination), major (consider therapy modification), moderate (monitor therapy) and minor interactions (no action needed) .…”

Section: Methodsmentioning

confidence: 99%

Mortality from adverse drug reaction-related hospitalizations in south-west Ethiopia: A cross-sectional study

et al. 2018

View full text Add to dashboard Cite

Fatal ADRs were common in patients presenting to hospital. The drugs implicated were mostly antitubercular and antiretroviral therapies, reflecting the high burden of HIV and tuberculosis in the study population. ADR-related deaths were significantly associated with poor nutritional status. The majority of ADR-related deaths were preventable, highlighting the need to develop a multidisciplinary approach to closely monitor patients who are prescribed antitubercular and antiretroviral therapies, particularly in patients with hepatic disease, a history of ADRs, who are malnourished and who are exposed to multiple medications.

show abstract

“…Calculation of the number of medications was based on the number of active ingredients [6], where the active ingredients in combination products were also available as single-ingredient products. Clinical diagnoses and comorbidities were coded according to the International Classification of Primary Care, 2 nd edition [14].…”

Section: Methodsmentioning

confidence: 99%

“…The proportion of all hospital admissions due to ADRs has ranged from 6–12% among older patients [1, 4–7]. While individual risk factors for ADRs have been identified [6, 8], health professionals are not able to easily identify elderly community-dwelling outpatients who are at high risk of being hospitalized due to an ADR. More than half of ADR-related hospitalizations are considered preventable [9].…”

Section: Introductionmentioning

confidence: 99%

Prediction of Hospitalization due to Adverse Drug Reactions in Elderly Community-Dwelling Patients (The PADR-EC Score)

et al. 2016

View full text Add to dashboard Cite

BackgroundAdverse drug reactions (ADRs) are the major cause of medication-related hospital admissions in older patients living in the community. This study aimed to develop and validate a score to predict ADR-related hospitalization in people aged ≥65 years.MethodsADR-related hospitalization and its risk factors were determined using a prospective, cross-sectional study in patients aged ≥65 years admitted to two hospitals. A predictive model was developed in the derivation cohort (n = 768) and the model was applied in the validation cohort (n = 240). ADR-related hospital admission was determined through expert consensus from comprehensive reviews of medical records and patient interviews. The causality and preventability of the ADR were assessed based on the Naranjo algorithm and modified Schumock and Thornton criteria, respectively.ResultsIn the derivation sample (mean [±SD] age, 80.1±7.7 years), 115 (15%) patients were admitted due to a definite or probable ADR; 92.2% of these admissions were deemed preventable. The number of antihypertensives was the strongest predictor of an ADR followed by presence of dementia, renal failure, drug changes in the preceding 3 months and use of anticholinergic medications; these variables were used to derive the ADR prediction score. The predictive ability of the score, assessed from calculation of the area under the receiver operator characteristic (ROC) curve, was 0.70 (95% confidence interval (CI) 0.65–0.75). In the validation sample (mean [±SD] age, 79.6±7.6 years), 30 (12.5%) patients’ admissions were related to definite or probable ADRs; 80% of these admissions were deemed preventable. The area under the ROC curve in this sample was 0.67 (95% CI 0.56–0.78).ConclusionsThis study proposes a practical and simple tool to identify elderly patients who are at an increased risk of preventable ADR-related hospital admission. Further refinement and testing of this tool is necessary to implement the score in clinical practice.

show abstract

Adverse drug reactions related to hospital admission in Slovak elderly patients

Cited by 31 publications

References 30 publications

Drug-Related Hospital Visits and Admissions Associated with Laboratory or Physiologic Abnormalities—A Systematic-Review

Drug-Related Hospital Visits and Admissions Associated with Laboratory or Physiologic Abnormalities—A Systematic-Review

Mortality from adverse drug reaction-related hospitalizations in south-west Ethiopia: A cross-sectional study

Prediction of Hospitalization due to Adverse Drug Reactions in Elderly Community-Dwelling Patients (The PADR-EC Score)

Contact Info

Product

Resources

About