Incidence and Factors Associated with Drug Related Hospital Admissions in a South Indian Tertiary Care Hospital

Abstract

Objective:The study aimed to assess the incidence, nature of drug related hospital admissions (DRHAs) and factors associated with DRHAs. Method: A retrospective study was conducted to evaluate the medical records of patients admitted to general medicine department for six months. Drug related hospital admissions were assessed using Helper and Stand Classification. Crude odds ratio (COR) and adjusted odds ratio (AOR) were determined using univariate and multivariate logistic regression analysis. Results: The results of analysis of 1177 medical records reveal that 202 (17.2%) patients were admitted due to 248 DRHAs. Of which, the most common DRHA was non-compliance that accounted for 50.50% (102). Out of 248 drug related hospital admissions, 65.8% (n=163) were definitely preventable, 30.2% (n=75) were possibly preventable and 4.0% (n=10) were definitely not preventable. However, multivariate regression analysis results indicate that hypertension, diabetes mellitus, and polypharmacy at admission are significantly (p< 0.001) associated with DRHA. Conclusion: The factors remarkably associated with drug related hospital admissions are age, diabetes mellitus, hypertension and polypharmacy. The major reasons for drug related hospital admissions are non-compliance and adverse drug reactions. Collaborative efforts among patients, physicians, pharmacists and caregivers might reduce the frequency of drug related hospital admissions.

Prevalence and predictors of drug-related hospitalisation among patients visiting emergency departments of Addis Ababa city hospitals in Ethiopia: a multicentre prospective observational study

“…The occurrence of DRH reported in this study (245, 57.9%) is substantially higher than studies conducted elsewhere, including America (16.2%), Brazil (31.6%), Denmark (10.8%), Norway (38%), Sweden (41.3%), India (17.2%) and Malaysia (39%) 3 6 7 18–20 26 27. The high prevalence in the current study could be explained by a number of reasons: (1) the categories of DRPs causing DRH in this study were comprehensive, while other studies investigated particular types of DRPs that resulted in DRH such as therapeutic failure27 and ADR2 26 28 29; (2) the prospective design of this study helps to ensure the gathering of all information required to accurately classify the events; (3) detailed histories of drug therapy obtained by clinical pharmacists might have improved detection of DRH; and (4) use of the Hepler and Strand’s comprehensive classification system has likely boosted the probability that all possible drug-related causes of hospitalisation be identified.…”

“…Of these, 50%–95% were preventable. Supratherapeutic dosage (10.3%–12.7%), non-compliance (10.6%–65.8%), ADRs (10.7%–45.5%) and untreated indications (10.7%–13.3%) were frequently identified as the causes of DRH 6 9 18 20–22…”

“…In the USA, DRPs accounted for 17 million emergency department (ED) visits and 8.7 hospitalisation events annually 17. It increases morbidity and mortality rates, and healthcare cost; decreases income and household productivity; and reduces quality of life 2 18 19…”

“…In many studies, drug-related hospitalised patients had mainly cardiovascular diseases and diabetes, suggesting that cardiovascular and hypoglycaemic medications were involved in DRH 6 10 11 18 20 21 24 25. Previous studies also identified polypharmacy, advanced age and comorbid conditions as factors that exacerbate the occurrence of DRH 3 6 20 21…”

Factores de riesgo para hospitalizaciones por reacciones adversas a medicamentos en un hospital de tercer nivel

“…El 52.9% de las RAM que motivaron ingresos hospitalarios fueron de intensidad severa, seguidas de las moderadas, con un 41.4%. Estos resultados difieren de los resultados encontrados por Dammalapati, et al 29 , en donde las moderadas son de mayor frecuencia (71.8%) que las severas (1.2%). La diferencia podría atribuirse a los conceptos aplicados.…”