Detecting Adverse Drug Reactions on Paediatric Wards

Haffner, Steffen; Laue, Nicoletta von; Wirth, Stéfan; Thürmann, Petra A.

doi:10.2165/00002018-200528050-00008

Cited by 48 publications

(9 citation statements)

References 39 publications

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“…Two studies covered general medicine and a hospital emergency department, [36], [37], and one study an integrated primary care information database [38]. Two studies were performed in the paediatric intensive care setting [39], one in combination with general paediatrics also [40]. Seven studies covered a combination of clinical settings [41]–[47].…”

Section: Resultsmentioning

confidence: 99%

“…The period under study varied widely and ranged from 1 day to ten years. The majority of studies where described as being performed in a general paediatric unit or ward (n = 24) [14], [19], [20], [22]–[26], [28], [34], [37], [51]–[54], [56]–[63], [85] two of which included intensive care also [64], [40]. Six studies were performed solely in the intensive care setting [39], [65]–[69], one of which included general medicine [70].…”

Section: Resultsmentioning

confidence: 99%

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Adverse Drug Reactions in Children—A Systematic Review

et al. 2012

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BackgroundAdverse drug reactions in children are an important public health problem. We have undertaken a systematic review of observational studies in children in three settings: causing admission to hospital, occurring during hospital stay and occurring in the community. We were particularly interested in understanding how ADRs might be better detected, assessed and avoided.Methods and FindingsWe searched nineteen electronic databases using a comprehensive search strategy. In total, 102 studies were included. The primary outcome was any clinical event described as an adverse drug reaction to one or more drugs. Additional information relating to the ADR was collected: associated drug classification; clinical presentation; associated risk factors; methods used for assessing causality, severity, and avoidability. Seventy one percent (72/102) of studies assessed causality, and thirty four percent (34/102) performed a severity assessment. Only nineteen studies (19%) assessed avoidability. Incidence rates for ADRs causing hospital admission ranged from 0.4% to 10.3% of all children (pooled estimate of 2.9% (2.6%, 3.1%)) and from 0.6% to 16.8% of all children exposed to a drug during hospital stay. Anti-infectives and anti-epileptics were the most frequently reported therapeutic class associated with ADRs in children admitted to hospital (17 studies; 12 studies respectively) and children in hospital (24 studies; 14 studies respectively), while anti-infectives and non-steroidal anti-inflammatory drugs (NSAIDs) were frequently reported as associated with ADRs in outpatient children (13 studies; 6 studies respectively). Fourteen studies reported rates ranging from 7%–98% of ADRs being either definitely/possibly avoidable.ConclusionsThere is extensive literature which investigates ADRs in children. Although these studies provide estimates of incidence in different settings and some indication of the therapeutic classes most frequently associated with ADRs, further work is needed to address how such ADRs may be prevented.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Adverse Drug Reactions in Children—A Systematic Review

et al. 2012

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“…Although the detection rate documented in 2008 (96.2%) might be slightly overestimated there was a significant increase in the physicians' attention to ADRs (p<0.001), which shows a positive development of ward staffs' alertness towards ADRs. A wide range of detection rates, between 42.5% in Neubert et al (2006), 89% in Aagaard et al (2010) and 91.1% in Haffner et al (2005) is reported in literature [4], [7], [43].…”

Section: Discussionmentioning

confidence: 96%

Adverse Drug Reactions in Hospitalised Children in Germany Are Decreasing: Results of a Nine Year Cohort-Based Comparison

Oehme

Rashed²,

Hefele

et al. 2012

PLoS ONE

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BackgroundIn recent years, efforts have been made to improve paediatric drug therapy. The aim of this research was to investigate any changes regarding the frequency and nature of adverse drug reactions (ADRs) in hospitalized children in one paediatric general medical ward over a 9-year period.MethodologyTwo prospective observational cohort studies were conducted at a large University hospital in Germany in 1999 and 2008, respectively. Children aged 0–18 years admitted to the study ward during the study periods were included. ADRs were identified using intensive chart review. Uni- and multivariable regression has been used for data analysis.ResultsA total of 520 patients (574 admissions) were included [1999: n = 144 (167); 2008: n = 376 (407)]. Patients received a total of 2053 drugs [median 3, interquartile range (IQR) 2–5]. 19% of patients did not receive any medication. Median length of stay was 4 days (IQR 3–7; range 1–190 days) with a significantly longer length of stay in 1999. The overall ADR incidence was 13.1% (95% CI, 9.8–16.3) varying significantly between the two study cohorts [1999: 21.9%, 95% CI, 14.7–29.0; 2008: 9.2%, 95% CI, 5.9–12.5 (p<0.001)]. Antibacterials and corticosteroids for systemic use caused most of the ADRs in both cohorts (1999; 2008). Exposure to systemic antibacterials decreased from 62.9% to 43.5% whereas exposure to analgesics and anti-inflammatory drugs increased from 17.4% to 45.2%, respectively. The use of high risk drugs decreased from 75% to 62.2%. In 1999, 45.7% and in 2008 96.2% of ADRs were identified by treating clinicians (p<0.001).ConclusionsBetween 1999 and 2008, the incidence of ADRs decreased significantly. Improved treatment strategies and an increased awareness of ADRs by physicians are most likely to be the cause for this positive development. Nevertheless further research on ADRs particularly in primary care and the establishment of prospective pharmacovigilance systems are still needed.

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“…Various trigger tools, for both prospective and retrospective application, and for both computerised and manual use, have been developed for medication‐related harm (adverse drug events; ADEs) in particular [2–4] and for adverse events in general [1,5,6] . Others are intended for the identification of adverse drug reactions (ADRs) alone [7–12] . Such methods are now becoming widely advocated for use outside of the USA, for example by the English Patient Safety First campaign (http://www.patientsafetyfirst.nhs.uk).…”

Section: Introductionmentioning

confidence: 99%

“…[1,5,6] Others are intended for the identification of adverse drug reactions (ADRs) alone. [7][8][9][10][11][12] Such methods are now becoming widely advocated for use outside of the USA, for example by the English Patient Safety First campaign (www.patientsafetyfirst.nhs.uk).…”

Section: Introductionmentioning

confidence: 99%