Rate, type, and cost of adverse drug reactions in emergency department admissions

Wasserfallen, Jean‐Blaise; Livio, Françoise; Buclin, Thierry; Tillet, Laurent; Yersin, Bertrand; Biollaz, J.

doi:10.1016/s0953-6205(01)00159-5

Cited by 64 publications

(68 citation statements)

References 15 publications

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“…A number of authors have reported nearly the same observations in studies by Javedh shareef et al, Jose J, Rao PGM, Arulmani R, Rajendran SD et al 13,15,16 We have also observed that most of the ADRs that lead to hospitalisation (in patients of group B) belonged to skin and GIT. This is also in agreement with others study, MG Lobo et al, Wasserfallen JB et al, Capuano A et al 12,17,18 It should be noted here that most of the suspected medications are administered by oral route and GIT falls an easy prey to all such medications. Moreover, establishment of a time relationship can be done easily in case of gastrointestinal adverse drug reactions.…”

Section: Discussionsupporting

confidence: 93%

An intensive monitoring of adverse drug reaction in indoor patients of medicine department at tertiary care teaching hospital

Darji

Jadav

Doshi

et al. 2016

Int J Basic Clin Pharmacol

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Section: Discussionsupporting

confidence: 93%

An intensive monitoring of adverse drug reaction in indoor patients of medicine department at tertiary care teaching hospital

Darji

Jadav

Doshi

et al. 2016

Int J Basic Clin Pharmacol

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“…Although major bleeding can occur at a therapeutic level, the risk of bleeding increases with increasing INR value [6]. Oral anticoagulants are frequently involved in adverse drug reactions (ADRs), especially haemorrhage, and are in the top ten drugs leading to hospital admissions due to ADRs [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Identification and weighting of the most critical “real-life” drug–drug interactions with acenocoumarol in a tertiary care hospital

Gschwind

Rollason

Lovis

et al. 2012

Eur J Clin Pharmacol

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Purpose The objective of this study was to identify the most clinically relevant drug-drug interactions (DDIs) at risk of affecting acenocoumarol safety in our tertiary care university hospital, a 2,000 bed institution. Methods We identified DDIs occurring with acenocoumarol by combining two different sources of information: a 1-year retrospective analysis of acenocoumarol prescriptions and comedications from our Computerized Physician Order Entry (CPOE) system (n = 2,439 hospitalizations) and a retrospective study of clinical pharmacology consultations involving acenocoumarol over the past 14 years (1994-2007) (n = 407). We classified these DDIs using an original risk-analysis method. A criticality index was calculated for each associated drug by multiplying three scores based on mechanism of interaction, involvement in a supratherapeutic international normalized ratio (INR) (≥ 6) and involvement in a severe bleeding.Results One hundred and twenty-six DDIs were identified and weighted. Twenty-eight drugs had a criticality index ≥ 20 and were therefore considered at high risk for interacting with acenocoumarol by increasing its effect: 75% of these drugs involved a pharmacokinetic mechanism and 14 % a pharmacodynamic mechanism. An unknown mechanism of interaction was involved in 11 % of drugs. Conclusion Twenty-eight specific drugs were identified as being at high risk for interacting with acenocoumarol in our hospital using an original risk-analysis method. Most analyzed drugs interact with acenocoumarol via a pharmacokinetic mechanism. Actions such as the implementation of alerts in our CPOE system should be specifically developed for these drugs.

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“…Thus far, studies have focused on inpatient populations, and little is known about ADE-related emergency department (ED) visits. In fact, many studies have approached the drug-related problem by observing hospital admissions, and only a few studies have estimated the drug-related problems in emergency departments [9,14,[16][17][18]. Moreover, most of these studies were conducted in university or tertiary hospitals, rather than in general hospitals.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, recent findings have reported that one-third are likely preventable [21] and that about half could be avoided with greater prescription care [22].…”

Section: Introductionmentioning

confidence: 99%

Regional surveillance of emergency-department visits for outpatient adverse drug events

Capuano

Irpino²,

Gallo

et al. 2009

Eur J Clin Pharmacol

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Aims To determine the (1) incidence of adverse drug events (ADEs) in 10 emergency department (EDs) of general hospitals in the Regione Campania (southern Italy), (2) rate of ADE-related hospital admissions, (3) drug classes most frequently involved, and (4) the types of ADEs and their frequency. Methods We performed a cohort study of all patients attending the EDs. This study was carried out in two observational periods of 10 days each in 10 EDs. Demographic, clinical, and pharmacological data about all patients admitted to EDs were collected by trained and qualified monitors. Records related to ADEs were analyzed and validated by a specific scientific committee. Results Of 7,861 ED visits, 96 were ADE-related. The incidence of hospitalization was higher in patients who had taken medication than in patients with a negative drug history (24.9 vs. 16.4%). ADEs were significantly more frequent in women. Patients aged between 60 and 69 years and between 30 and 39 years were significantly more likely to experience an ADE. Serious ADEs were identified in 20 ED visits (20.8% of total sample). Antibiotics, NSAIDs, and agents acting on the renin-angiotensin system were the drugs most often involved in ADEs. In multivariate analyses, the adjusted odds ratio was 3.4 (95% CI: 1.07-2.84) for patients taking NSAIDs, 4.78 (95% CI: 2.26-10.12) for those taking β 2 -adrenergic-receptor agonists, and 6.20 (95%CI: 2.74-14.06) for those taking β-lactam antibiotics. Conclusion This study shows that ADEs are an important problem in industrialized countries. Moreover, it shows that ADEs affect hospital admission rates and reinforces the importance of drug-induced disease as a public health problem.

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Rate, type, and cost of adverse drug reactions in emergency department admissions

Cited by 64 publications

References 15 publications

An intensive monitoring of adverse drug reaction in indoor patients of medicine department at tertiary care teaching hospital

An intensive monitoring of adverse drug reaction in indoor patients of medicine department at tertiary care teaching hospital

Identification and weighting of the most critical “real-life” drug–drug interactions with acenocoumarol in a tertiary care hospital

Regional surveillance of emergency-department visits for outpatient adverse drug events

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