Incidence of Adverse Drug Reactions in Hospitalized Patients

Lazarou, Jason; Pomeranz, Bruce; Corey, Paul

doi:10.1001/jama.279.15.1200

Cited by 4,022 publications

(942 citation statements)

References 38 publications

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“…However, the few studies that are available have shown that there are some important predictors for the occurrence of iatrogenic events, namely, older age [10,11,14,[18][19][20][21], longer hospital stay [5,10,15,[18][19][20][21], number of drugs taken daily [11,15,18,21,32], associated pathologies [21], poor general medical status on admission [19], associated renal function impairment or failure [18], and IV catheterization [19]. Amongst the many types of iatrogenic diseases, the most common seem to be drugrelated [6,9,10,12,16,21,23,[30][31][32][33] or adverse drug reactions (ADRs). ADRs are frequent, costly and, in some cases, responsible for severe complications [6].…”

Section: Introductionmentioning

confidence: 99%

“…Older patients tend to suffer more type A reactions, whereas type B reactions seem to occur more often in younger patients [2,23]. In the published studies, some 16-50% of all ADRs are serious [12,14,[18][19][20]30] and 22-80% avoidable/preventable [6,9,10,16,[20][21][22]. Some authors suggest strategies to fight this "pandemic", including enhanced educational programs from the pre-graduate to post-graduate level, aimed at prescribing physicians, patients, the general public, the pharmaceutical industry, health authorities, epidemiologists, and medical educators; measures of risk reduction (e.g., decreasing hospital stay, number of drugs, and technical procedures); the setting up of databases or electronic systems to diminish errors and ADRs; and determined efforts to improve ambulatory care [6,[12][13][14]16,17,19,20,23,34].…”

Section: Introductionmentioning

confidence: 99%

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The diseases we cause: Iatrogenic illness in a department of internal medicine

Madeira

Melo

Porto³

et al. 2007

European Journal of Internal Medicine

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Background: The aim of this study was to estimate the incidence, main causes, and risk factors of iatrogenic disease occurring in a department of internal medicine. Methods: Over a 1-year period, physicians systematically filled out a 2-page questionnaire for all patients admitted to the ward. A database was created and the data were statistically analyzed. Patients undergoing immunosuppressive, chemo-, or radiation therapy were excluded. Missing data were completed by reviewing the patients' charts. The patients were then divided into two groups: those with and those without iatrogenic disease. The groups were compared using several parameters including gender, age, social features, days of hospitalization, associated illness, functional status, medical impression, prognosis, associated renal or liver function impairment, drugs taken daily, and outcome. In the group with iatrogenic disease, the type, severity, and predictability were also analyzed. Results: Of the 879 patients admitted to the ward, 445 completed questionnaires and were included in the study. A total of 102 patients (22.9%) developed 121 iatrogenic events. Forty-four patients (43.1%) were admitted for iatrogenic illness, 10 (9.8%) developed lifethreatening events, and in 3 (6.8%) it was the cause of death. Fifty-eight patients (56.8%) registered 77 episodes of iatrogenic disease during their hospital stay, 20 (19.6%) developed life-threatening events, and 9 (11.7%) died, 4 (5.2%) of an iatrogenic cause (nosocomial infections). Significant differences were found in 20 out of 26 parameters studied ( p b 0.005 for all cases; 95% confidence interval). Eighteen percent of all iatrogenic disease was severe, 61.9% predictable, 54.5% avoidable, and 59% drug-related, 80% of which was due to side effects or adverse reactions. Infection and metabolic and electrolyte disorders were the most frequent effects. Conclusions: It is possible to identify risk factors for iatrogenic events. Chronically ill elderly inpatients are the main target of iatrogenic events.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The diseases we cause: Iatrogenic illness in a department of internal medicine

Madeira

Melo

Porto³

et al. 2007

European Journal of Internal Medicine

View full text Add to dashboard Cite

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“…Table 4 provides a list of drugs that might cause or contribute to cognitive impairment in older adults. 60,[66][67][68][69] If cognitive or sensory deficits are identified, the pharmacist should recognize and eliminate druginduced effects and adjust patient counseling to the level the patient or caretaker can understand and retain.…”

Section: Sensory and Memory Deficitsmentioning

confidence: 99%

“…72 Table 5 provides a list of drugs that can contribute to falls. [67][68][69][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88] Pharmacists should pay particular attention to these drugs when they are used in older adults, especially if the older adults have a history of falls. Conditions affecting gait and cognitive function include Parkinson' s disease, dementia with Lewy bodies, lower limb fractures, stroke, arthritis, and Alzheimer's disease.…”

Section: Mobility Falls and Fracturesmentioning

confidence: 99%

Pharmacy Practice, Research, Education, and Advocacy for Older Adults

et al. 2005

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In the United States, older adults have become the fastest growing segment of the population and are expected to double in number to 70 million by 2030. As a whole, older adults have different health care needs than younger patients, and some of these needs should be met by pharmacists. Clinical pharmacy practice affecting older adults occurs in a variety of settings, including community, ambulatory care, primary care, hospital, assisted living, nursing home, home health care, hospice, and Alzheimer's disease units. Although specialty training in geriatrics or gerontology is not required for pharmacists to care for older adults, it is extremely helpful. Pharmacy education related to the care of older adults has improved slightly in the past several years but will need to increase even more to provide all pharmacists with the basic skills and knowledge to care for this unique group of patients. In addition, pharmacotherapy research targeting older adults needs to increase. Although it can be challenging, funding for this type of research is available. Patient and political advocacy is also important to support this growing population.

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“…12,33 Alongside their perceived benefits, drugs are known to be associated with a range of dangers, including drug interactions and resistance, iatrogenic effects, accident, dependence, overdose, mental illness, hospitalisation and death (these dangers are associated equally with the misuse of certain medications, and are not the exclusive province of prohibited substances). [34][35][36] Aware of these dangers, international agencies and experts are increasingly inclined to call on governments to end the criminalisation of illicit drug use and possession 37-39 -though not without encountering local resistance. Promising health outcomes have been achieved in jurisdictions where less punitive policies are implemented, 40,41 and a range of programs have emerged locally and internationally that seek to provide non-judgmental care and resources to users, including pill testing, syringe provision, peer outreach services and supervised injecting.…”

Section: Introductionmentioning

confidence: 99%

The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men

et al. 2017

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Abstract. There are complex historical connections between sexual minoritisation and desires to chemically alter bodily experience. For gay men, drug and alcohol use can be a creative or experimental response to social marginalisation -and not necessarily a problematic one in every instance. Numerous studies have found that infection with HIV and other sexually transmissible infections (STIs) is more likely among gay and men who have sex with men (MSM) who use recreational drugs than those who do not, but the causal nature of these relations is uncertain. Sexualised drug use is associated with a range of other problems, including dependence, mental health issues, accident and overdose. A growing body of work in the Alcohol and Other Drugs (AOD) field demonstrates the action of drugs and their purported effects to be a product of their relations with various other actors, contexts and practices. Given these contingencies, it is impossible to predict the future of drugs or their effect on the sexual health of gay and MSM with any degree of certainty. This article outlines some of the conditions most likely to mediate such futures in the medium term. Public funding for lesbian, gay, bisexual, transgender and queer drug issues should not remain restricted to questions of HIV prevention and sexual health. It should be expanded to equip sexual health and AOD service providers with the cultural and sexual literacy to mitigate stigma and allow them to respond constructively to drug problems among sexual and gender minorities as a matter of priority.

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Incidence of Adverse Drug Reactions in Hospitalized Patients

Cited by 4,022 publications

References 38 publications

The diseases we cause: Iatrogenic illness in a department of internal medicine

The diseases we cause: Iatrogenic illness in a department of internal medicine

Pharmacy Practice, Research, Education, and Advocacy for Older Adults

The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men

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