Prevalence, risk factors and main features of adverse drug reactions leading to hospital admission

Pedrós, Consuelo; Quintana, Beatriz; Rebolledo, Mireia; Porta, Núria; Vallano, Antonio; Arnau, Josep Maria

doi:10.1007/s00228-013-1630-5

Cited by 101 publications

(128 citation statements)

References 41 publications

Supporting

Mentioning

106

Contrasting

Unclassified

Order By: Relevance

“…People with cognitive impairment are even more vulnerable to ADRs than those without cognitive impairment due to the neurochemical changes in neurotransmitter substances that occur especially in people with dementia [1]. The ADRs may also occur at a higher frequency, and to a higher degree, among this patient group [1, 6], and it is seen that the risk of experiencing ADRs increases among old people (OR 1.59, 95% CI 1.10–2.29) [7]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An evaluation of the prevalence of potentially inappropriate medications in older people with cognitive impairment living in Northern Sweden using the EU(7)-PIM list

Sönnerstam

Sjölander

Gustafsson

2017

Eur J Clin Pharmacol

View full text Add to dashboard Cite

PurposeAs people get older, their sensitivity to drugs and adverse drug reactions can increase due to pharmacokinetic and pharmacodynamic changes. Older people with dementia are a particularly vulnerable group of people. They are at an increased risk of being prescribed potentially inappropriate medications, which may lead to harmful consequences. The aim of this study was to investigate the prevalence of potentially inappropriate medications among older patients with cognitive impairment.MethodsMedical records for patients aged ≥65 years admitted to two hospitals in Northern Sweden were reviewed. Potentially inappropriate medications were identified using the EU(7)-PIM list as an identification tool.ResultsOf 428 patients included in the study, 40.9% had one or more potentially inappropriate medication prescribed. The most commonly represented potentially inappropriate medication classes were hypnotics and sedatives, cardiovascular drugs and laxatives. The most commonly involved potentially inappropriate medications were zopiclone, digoxin and sodium picosulfate. There was an association seen between having a higher number of medications prescribed and having one or more potentially inappropriate medication.ConclusionPotentially inappropriate medications are prevalent among older people with cognitive impairment living in Northern Sweden. It is important to continuously evaluate the need for potentially inappropriate medications in this patient group, in order to prevent adverse drug reactions, especially among those who have a higher number of medications prescribed.Electronic supplementary materialThe online version of this article (doi:10.1007/s00228-017-2218-2) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Older people with cognitive impairment are particularly vulnerable to drug effects and ADRs, and it is seen that hospital admissions among this patient group are often due to ADRs [3, 7, 20]. It is therefore important to identify and pay attention to PIM use in order to improve the drug use among this vulnerable group of people.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of the prevalence of potentially inappropriate medications in older people with cognitive impairment living in Northern Sweden using the EU(7)-PIM list

Sönnerstam

Sjölander

Gustafsson

2017

Eur J Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…12,16 To date, the majority of studies addressing the problem of polypharmacy have been in the geriatric population where the risk for adverse drug reactions has been shown to be associated with the number of drugs taken. 17,18 Of the few studies that have examined polypharmacy in the SCI population, a recent retrospective study of 175 patients with chronic SCI reported over 300 drugs being administered in more than 19 classes of medications. 19 In addition, a recent study examined the combination use of opoid and anticonvulsant therapy for neuropathic pain in the SCI population.…”

Section: Introductionmentioning

confidence: 99%

The risks of polypharmacy following spinal cord injury

Kitzman

Cecil

Kolpek

2016

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

Objective: The purpose of this study was to examine the overall prevalence of polypharmacy within the spinal cord injury (SCI) population, the level of polypharmacy with respect to seven classes of high-risk drugs commonly used to treat secondary conditions in the SCI population, and the overall risks for drug-related problems (DRP) related to polypharmacy. Design: A retrospective case-control design. Setting: A commercially available claims dataset that included patient cases from 4800 hospitals in the USA between 2007 and 2009. Participants: Individuals with tetraplegia, paraplegia, and those with SCI but not specified as either tetraplegia or paraplegia as well as a control population of randomly selected, age-and sex-matched individuals without a diagnosis of SCI. Outcome measures: The overall prevalence of polypharmacy, the prevalence of commonly prescribed high-risk medications, and the prevalence of reported DRPs. Results: Overall, the patients in the SCI population were prescribed significantly more medications than their control counterparts. There was a higher rate of individuals being prescribed medications from multiple highrisk classes (e.g. analgesic-narcotics, anticonvulsant, antidepressant, and skeletal muscle relaxer), as well as multiple medications within each class (e.g. multiple analgesic-narcotics). The SCI group had a higher incidence of DRPs. Conclusion: Our results are some of the first to demonstrate the extent of polypharmacy in individuals with SCI, including commonly prescribed high-risk medications, leading to a higher rate of DPRs. The higher rate of polypharmacy and DRPs can impact rehabilitation goals and community integration following neurologic injury.

show abstract

“…Pedrós y colaboradores titulado Prevalencia, factores de riesgo y principales características de las reacciones adversas a los medicamentos que conducen a la hospitalización 8 , el cual se realizó durante un periodo de 120 días, encontrándose que la polifarmacia y la edad eran los principales factores de riesgo para desarrollar reacciones adversas, lo cual se incrementaba con el número de medicamentos que usaban al momento de la admisión al hospital: 3-5 drogas con un OR 5.07 (IC 95% 2.71 -9.59), 6-9 drogas OR 5.90 (IC 95% 3.16-11.96), > 10 drogas OR 8.94 (IC 95% 4.73-16.89). Al compararse estos resultados con nuestra investigación, se encuentra resultados similares; en nuestro estudio un probable exceso de riesgo para presentar RAM fue la polifarmacia (> 5 medicamentos) con un OR 3.30 IC 95% 1.96-5.57 cuando se ajustaron varios confusores.…”

Section: Discussionunclassified

Prevalencia y factores asociados a la presencia de reacciones adversas a medicamentos en los pacientes tratados por medicina interna en el Hospital Universitario Hernando Moncaleano Perdomo

Rangel

Rojas

López

et al. 2016

Rev. Médica Risaralda

View full text Add to dashboard Cite

Prevalencia y factores asociados a la presencia de reacciones adversas a medicamentos en los pacientes tratados por medicina interna en el Hospital Universitario Hernando Moncaleano Perdomoadverse reactions for medicines (ADR) that come from to 31.34% of sample, the 52,4% were male with an average age of 58,5 years old. The ADR were classified according to their production mechanism in A sort 79%, B sort 14% and C sort 5%; the majority were minor in the 88% of cases. The main pharmacological system affected was the gastrointestinal followed by the hematological in 22% and 19% respectively; the enoxaparin was the main drug associated with the ADR production in the 17%, so is the drug with more drug interactions together to the acetylsalicylic acid in the 26% of the cases. Among the associated factors for the ADR production are the polypharmacy IC: 1.96-5.57, p 0.000027 and the drug interactions IC: 1.32 -3.81, p 0.0011. Conclusions: the drug interactions and the polypharmacy are the associated factors to the presence of adverse reactions to medicines in internal medicine patients. Keywords: Abnormalities, Drug-Induced, Drug Combinations, Drug Interactions IntroducciónLas reacciones adversas a medicamentos (RAM) constituyen un problema de salud pública. En un meta-analisis realizado por Bouvy y cols. El porcentaje de admisiones a los centro de urgencias por reacciones adversas a medicamentos fue de 3.5% y un 10.1% de los pacientes presenta alguna RAM durante su estancia hospitalaria 1 . también se ha reportado que alrededor del 5% de todas las hospitalizaciones se atribuye a algún tipo de reacción adversa, y el 20% de los pacientes hospitalizados pueden presentar las RAM 2 . Estos eventos disminuyen la calidad de vida de los enfermos, prolonga la estancia hospitalizaría, aumenta la morbi-mortalidad, ocasiona perdida de la confianza en los médicos y eleva el costo de la atención médica. Los resultados de los estudios clínicos realizados antes de la comercialización, tienen ciertas limitaciones en cuanto al número de personas expuestas a medicamentos, tiempo de exposición al mismo y la generalización de los resultados a la población en general. Para este estudio se denomina interacción medicamentosa a toda identificación que se pueda producir sobre la farmacocinética o farmacodinamia del medicamento, debido a la interacción con compuestos endógenos o exógenos como ocurre en la administración simultanea de otros fármacos y demás factores como alimentos, bebidas o contaminantes ambientales 3 .Existen muchos factores de riesgo para el desarrollo de reacciones adversas a medicamentos entre los cuales se encuentran la polifarmacia y las alteraciones farmacocinéticas propias de los pacientes críticos. Sin embargo la cultura del reporte de las reacciones adversas no está bien establecida en muchos sitios, por lo cual hay pocos reportes de estos eventos en pacientes hospitalizados y ambulatorios 2 . Jason Lazarou y colaboradores en un meta-análisis de la incidencia de las reacciones adversas a medicamentos en los pacientes ...

show abstract

Prevalence, risk factors and main features of adverse drug reactions leading to hospital admission

Abstract: Over 4 % of urgent hospitalizations are caused by ADRs, which are dose-related and predictable in more than 90 % of cases. The main risk factors are advanced age and polypharmacy.

Cited by 101 publications

References 41 publications

An evaluation of the prevalence of potentially inappropriate medications in older people with cognitive impairment living in Northern Sweden using the EU(7)-PIM list

An evaluation of the prevalence of potentially inappropriate medications in older people with cognitive impairment living in Northern Sweden using the EU(7)-PIM list

The risks of polypharmacy following spinal cord injury

Prevalencia y factores asociados a la presencia de reacciones adversas a medicamentos en los pacientes tratados por medicina interna en el Hospital Universitario Hernando Moncaleano Perdomo

Contact Info

Product

Resources

About