Patient Risk Factors for Adverse Drug Events in Hospitalized Patients

Bates, David W.; Miller, Elizabeth; Cullen, David J.; Burdick, Lisa; Williams, Lawrence; Laird, Nan M.; Petersen, Laura A.; Small, Stephen D.; Sweitzer, Bobbie Jean; Vliet, Martha Vander; Leape, Lucian L.

doi:10.1001/archinte.159.21.2553

Cited by 304 publications

(217 citation statements)

References 43 publications

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“…Studies have shown that age, gender, co morbidity, number of drugs, and length of hospital stay are significant risk factors for development of ADRs [36,[39][40][41][42][43][44]. Our study revealed polypharmacy and multiple disease state as the most prevalent predisposing factors in patients who developed ADRs.…”

Section: Discussionmentioning

confidence: 52%

Spontaneous reporting of adverse drug reactions at a department of Internal Medicine

et al. 2010

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AbstractThe aim of the present study was to characterize the pattern of adverse drug reactions (ADRs) reported in a university teaching hospital in south-east Serbia. The study was conducted based on ADRs reported during a six-month period to the ADR reporting unit of the university clinical center. Evaluation of data was done for various parameters, such as patient demographics, drug and reaction characteristics, and outcome of reactions. Assessment was also done for causality, severity and predisposing factors. During the 6-month study period, 44 ADRs were reported, with an overall incidence of 0.33%. No significant difference was seen in the overall incidence of ADRs observed in males and females. Incidence of ADRs among elderly (43.2%) and older (25%) adults was significantly higher than in other age groups. Type A reactions (66.7%) accounted for majority of the reports. The most commonly affected organ system was the renal system, (22.7%) with hyperkalemia as the only reported reaction. ACE inhibitors (48.6%) were the drug class most commonly involved, where fosinopril (25.7%) was the individual drug most frequently reported. Additional treatment was pursued for management of ADRs in majority (52.3%) of the reports. In 52.3 % of the reports, the patient had recovered from the reaction by the time of evaluation. Upon causality assessment, the majority of the reports were rated as probable (43.2%). Mild and moderate reactions accounted for 43.2% and 54.6%, respectively. In 36.3% of the reports, the reaction was considered to be preventable. The most common predisposing factors were polypharmacy and multiple disease state. The pattern of ADRs reported in our hospital is comparable to the results of studies conducted in hospital set up elsewhere. Our evaluations revealed opportunities for intervention to ensure safer drug use.

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Section: Discussionmentioning

confidence: 52%

Spontaneous reporting of adverse drug reactions at a department of Internal Medicine

et al. 2010

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“…Thus, inter-rater reliabilities ranged from poor to excellent (kappa 0.19-0.98; overall agreement 26-97%). Of the 24 (17%) articles that reported excellent reliability of the preventability assessment (kappa >0.81), one study used an explicit algorithm in the fourth group (36) and 23 used more implicit methods (8,9,22,(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56). In four (3%) articles, reliability assessments were mentioned, but as no exact figures for the reliability of the preventability assessment were presented, the articles are not presented in Table IV (24,57,58).…”

Section: Resultsmentioning

confidence: 99%

Methods for Assessing the Preventability of Adverse Drug Events

et al. 2012

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“…Studies in the United States, United Kingdom, and Australia indicate that errors or adverse events occur in the range of 1.1% to 16.6% of all hospital admissions, [3][4][5][6] with many showing a greater incidence with age, complexity, and acuity of the patient. 3,[7][8][9][10][11] Analysis of malpractice claims indicates that diagnostic error is both the leading cause of paid claims and the most costly category. 12,13 However connecting error types to actual error rates from audits, selfreports, and other databases without a known denominator is not possible.…”

Section: Diagnostic Error In Medicine and Critical Carementioning

confidence: 99%