Hospitalisation for adverse events related to drug therapy: incidence, avoidability and costs

Abstract

Objectives To determine the incidence of hospital admissions for adverse events related to drug therapy, and to assess whether these drug‐related admissions (DRAs) could have been reasonably prevented. Setting A tertiary teaching hospital. Design and patients Prospective assessment of all admissions through the emergency department and resulting in a stay of more than 24 hours during 30 consecutive days in November and December 1994 to determine if the admission was related to drug therapy. Cases of intentional overdose were excluded. Main outcome measures The number, type, causality and avoidability of drug‐related admissions. Results Of 965 admissions, 55 (5.7%) were assessed as being drug‐related. Drug‐related admissions (DRAs) were designated possibly (38%), probably (46%) or definitely (16%) drug‐related; caused by prescribing factors (26%), patient noncompliance (27%) and adverse drug reactions (47%); and classified as definitely (5.5%), possibly (60.0%) and not (34.5%) avoidable. The estimated annual cost to the hospital for all DRAs was $3496956 and for unavoidable DRAs was $1629494. Conclusion The DRA rate we found lies around the middle of the range of other published rates. Few DRAs were judged definitely avoidable and over one‐third were unavoidable. Nevertheless, the largest proportion were judged possibly avoidable. As the drugs identified in this study are clearly needed in the community, efforts to reduce DRAs must concentrate on education, counselling and monitoring of drug therapy.

Percentage of Patients with Preventable Adverse Drug Reactions and Preventability of Adverse Drug Reactions – A Meta-Analysis

“…We did not identify any studies in primary care without a hospitalisation or emergency visit. Nine studies were conducted in Europe [28]-[31], [33]-[37], two in Australia [25], [27], four in North America [23], [24], [26], [38], and one India [32]. The studies were conducted between 1992 and 2006.…”

“…Three studies were conducted exclusively in the elderly (≥65 years) [24], [27], [34]. Except for two studies [24], [32], all assessed the preventability by the consensus of at least two professionals [23], [25]-[31], [33]-[38]. For determining preventability, the criteria introduced by Hallas [39] were used in nine of the 16 studies [24], [27], [31]-[35], [37], [38], and Schumock’s criteria [40] in four [23], [29], [30], [36].…”

Correlation versus Causation? Pharmacovigilance of the Analgesic Flupirtine Exemplifies the Need for Refined Spontaneous ADR Reporting

“…Consequently, ADRs are a leading cause for market removal of drugs [1]–[4] with drug-induced toxicities ranking among the top 10 causes of death in the US to result in health care costs of $30 billion US Dollars annually [5], [6]. Here, drug-induced liver injury (DILI) is the most frequent ADR and accounts for more than 50% of all cases of acute liver failure in the United States today [7].…”

Anticoagulant therapy: we have to do better! A systematic review

“…In older studies, differences of up to 10% were presented concerning anticoagulant-related hospital admissions4 5 In 2006, Howard et al published a systematic review to estimate the percentage of preventable drug-related hospital admissions, the most common drug causes of these admissions and the underlying causes. In previous reviews, 4.3% of preventable hospital admissions were related to medication but there was no further information about the type of medication.…”