Abstract:Similar to departments of internal medicine, a high number of ADRs occur on neurological wards. The predominant ADRs were those typical of neurotropic medications such as dyskinesia and increased sedation. Due to the age of the patients involved, cardiovascular co-medication is often prescribed and represents an additional risk factor for ADRs. By measuring pathological laboratory parameters the majority of ADRs could not be detected in neurological patients.
“…3 ). In these studies, the percentage of patients who were admitted to the hospital due to an ADR varied from 0.5 % [ 21 ] to 12.8 % of all patients [ 24 ]. Fig.…”
Adverse drug reactions (ADRs) cause considerable mortality and morbidity but no recent reviews are currently available for the European region. Therefore, we performed a review of all epidemiological studies quantifying ADRs in a European setting that were published between 1 January 2000 and 3 September 2014. Included studies assessed the number of patients who were admitted to hospital due to an ADR, studies that assessed the number of patients who developed an ADR during hospitalization, and studies that measured ADRs in the outpatient setting. In total, 47 articles were included in the final review. The median percentage of hospital admissions due to an ADR was 3.5 %, based on 22 studies, and the median percentage of patients who experienced an ADR during hospitalization was 10.1 %, based on 13 studies. Only five studies were found that assessed ADRs occurring in the outpatient setting. These results indicate that the occurrence of ADRs in the European hospital setting—both ADRs that result in hospitalization and ADRs that occur during the hospital stay—is significant. Furthermore, the limited number of studies that were performed in the outpatient setting identify a lack of information regarding the epidemiology of ADRs in this setting.
“…3 ). In these studies, the percentage of patients who were admitted to the hospital due to an ADR varied from 0.5 % [ 21 ] to 12.8 % of all patients [ 24 ]. Fig.…”
Adverse drug reactions (ADRs) cause considerable mortality and morbidity but no recent reviews are currently available for the European region. Therefore, we performed a review of all epidemiological studies quantifying ADRs in a European setting that were published between 1 January 2000 and 3 September 2014. Included studies assessed the number of patients who were admitted to hospital due to an ADR, studies that assessed the number of patients who developed an ADR during hospitalization, and studies that measured ADRs in the outpatient setting. In total, 47 articles were included in the final review. The median percentage of hospital admissions due to an ADR was 3.5 %, based on 22 studies, and the median percentage of patients who experienced an ADR during hospitalization was 10.1 %, based on 13 studies. Only five studies were found that assessed ADRs occurring in the outpatient setting. These results indicate that the occurrence of ADRs in the European hospital setting—both ADRs that result in hospitalization and ADRs that occur during the hospital stay—is significant. Furthermore, the limited number of studies that were performed in the outpatient setting identify a lack of information regarding the epidemiology of ADRs in this setting.
“…Though, intensive monitoring could give the most reliable gures on the incidence and the pattern of ADRs and thereby helps to design improvement strategies for drug safety and safe use [15]. However, continuous intensive monitoring programmes are costly and time-consuming [16,17].…”
Background: Monitoring and detecting adverse drug reactions (ADRs) in hospitals is crucial to improving drug safety and healthcare delivery quality. Nevertheless, there was not enough information on ADR incidence and its figure in Iran. Aim: this study aimed to determine the incidence of ADRs in hospitalized patients and investigate their characteristics in Iran.Methods: We conducted a three-month prospective study in two tertiary hospitals in 2019. All admitted patients were intensively monitored for all suspected ADRs through daily visiting hospital wards and soliciting information from physicians, nurses and interviewing suspicious patients. We calculated the incidence of ADRs, and 95% confidence intervals (95% CI). Poisson regression was used to evaluate risk factors for ADR incidence. Results: Among 13,613 admitted patients, we detected 115 ADRs in 114 patients. The incidence of ADR was 8.4 per 1000 admissions (95% CI: 7.0-10.1), and 13.9% of them were ADR-related hospital admissions. The risk of ADRs was significantly predicted by age, length of hospital stay, patients’ diagnostics, number of drug usage, and using respiratory system agents and anti-infectives for systemic use. The most common ADRs were skin and subcutaneous manifestations (52.2%), and 62.6% of ADRs were caused by anti-infectives (commonly vancomycin, ceftriaxone, and ciprofloxacin). Conclusion: This study indicated that ADRs occurrence during the hospital stay or resulting in hospital admissions are considerable. Given that ADR occurrence could be associated with increased morbidity, mortality, and economic burden, constant intensive monitoring is required to address the drug safety issue and promote actions to improve patient safety and reduce the health and economic burden.
“…Out of all ADRs identified by retrospective chart review, ∼ 60% could also be detected by pathological laboratory values ordered for clinical routine investigation [13] in Internal Medicine departments, and < 50% of ADRs could be observed by pathological laboratory values in departments of Neurology [14] and Paediatrics [15]. The overlap between the ADEs detected by computerised monitoring and ward-based intensified monitoring has been described as being surprisingly small [10,14,15].…”
Section: Methods For Detection Of Adverse Drug Eventsmentioning
confidence: 99%
“…In the next step, the positive predictive value of each potential trigger signal has to be calculated after a certain time and the decision must be made as to whether or not this trigger signal should remain in the system [10]. One of the advantages offered by this method is the chance to detect ADEs early during their development and the opportunity for physicians to react before organ function deteriorates: although ADRs announced by pathological laboratory values in Neurology were of a low severity grade, 50% were followed by changes in drug therapy [14]. Despite the fact that such a system clearly improves patient safety and contributes to cost savings [16], healthcare providers and hospital administrators still seem reluctant to invest in such systems [10].…”
Section: Methods For Detection Of Adverse Drug Eventsmentioning
Adverse drug events (ADEs) contribute significantly to patient morbidity and mortality as well as to cost for healthcare providers and society. Since only serious ADEs will result in hospitalisation, the evaluation of ADEs leading to hospitalisation reflects safety and appropriateness of ambulatory prescribing. ADEs occurring during hospitalisation may result from the special clinical situation of hospitalised patients; high degree of severity of diseases (e.g., renal failure, necessity of intensive care) and specific drugs administered only in hospitals. Moreover, the number of diagnostic and therapeutic procedures carried out daily puts the hospitalised patient at an extremely high risk for ADEs.
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