Reasons for inpatient admissions to the dermatology department in Lomé, Togo : Trends between 1992 to 2005 and 2005 to 2016

Adedeji

et al. 2020

Brit J Clinical Pharma

Prospective cohort study on 1280 adult patients admitted to the medical wards of a tertiary institution over 12 months. Patients were assessed for ADRs during and throughout admission; causality and preventability of ADRs were assessed. Results: Sixty-seven (5.2%) patients had ADRs, 51 (3.9%) caused hospitalisation while 17(1.3%) occurred during hospitalisation, and 42 (62.7%) of total ADRs were preventable. Nonsteroidal anti-inflammatory drugs, 14 (20.3%), antidiabetics, 12 (17.4%) and antibacterial, 11 (15.8%) were the most implicated drug classes. Gastrointestinal tract (37%), central nervous system (30.2%), and skin (24.7%) were the most affected organ/systems, while upper gastrointestinal bleeding and hypoglycaemia were the most observed ADRs. ADRs led to deaths in 7 (10.4%) patients, with an overall case fatality rate of 0.5%. The highest number of deaths were among patients with Stevens-Johnson syndrome 2/7 (28.6%) and hepatotoxicity 2/7 (28.6%). Risk factors, adjusted odds ratio (AOR [95% confidence interval, CI]) for ADRs leading to hospitalisation was male sex 3.11 (1.11, 8.73) while for ADRs during hospitalisation were number of drugs used before admission (AOR [95% CI] = 6.67 [1.16, 38.47]) and comorbidities (AOR [95% CI] = 3.0 [1.13, 8.01]). Patients admitted with ADRs had prolonged hospital stay (AOR [95% CI] = 3.37 [1.11, 8.71]). Conclusion: Preventable ADRs are common and important causes of hospitalisation and inpatients' morbidity and mortality among medical patients in Nigeria. Upper gastrointestinal bleeding and hypoglycaemia, resulting from nonsteroidal antiinflammatory drugs and antidiabetic drugs were the most observed ADRs.

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Cohort study on adverse drug reactions in adults admitted to the medical wards of a tertiary hospital in Nigeria: Prevalence, incidence, risk factors and fatality

Adedeji

et al. 2020

Brit J Clinical Pharma

“…Cotrimoxazole in Nigeria and most LMICs are obtained as an over-the-counter drug, and this easy accessibility and affordability increase the predisposition to this lifethreatening ADRs. Studies have reported SJS/TEN as common fatal ADRs reported in developing countries [32,33]. Some drugs reported as having high risks of causing SJS/TEN are anti-infective sulfonamide, antiepileptic drugs, nevirapine and herbal medications [33], similar to our findings.…”

Section: Discussionsupporting

confidence: 89%

Prospective cohort study on adverse drug reactions on all admissions to internal medicine: Incidence, risk factors and fatality

Adedapo¹,

Adedeji²,

Adedapo³

et al. 2020

Preprint

Background Adverse drug reactions (ADRs) constitute major clinical burden of public health concern. Intensive adverse drug reactions monitoring in hospitals, though advocated are rare. Aims Intensive monitoring of medical patients for ADRs to assess incidence, risk factors and fatality of ADRs leading to hospital admission or occurring in the hospital. Research design and methods Prospective cohort study on 1280 adult patients admitted to the six medical wards of a tertiary institution over a 12-month period. Patients were assessed for ADRs during and throughout admission. Causality assessment and preventability of ADRs were assessed. Results Sixty-seven (5.2%) patients had ADRs, which was the cause of admission in 46 (3.6%), and majority 61(91%) of the ADRs were preventable. NSAIDs, 14 (20.3%), antidiabetics, 12 (17.4%) and antibacterial, 11 (15.8%) were the most suspected drugs. Gastrointestinal tract (37%), CNS (30.2%), and skin (24.7%) were the most affected organ/systems, while upper GI bleeding and hypoglycaemia were the most observed ADRs. ADRs led to deaths in 7(10.4%) patients, with overall case fatality rate of 0.5%. Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis 3/7(42.9%) had the highest fatality rate. Risk factors, relative risk, 95% confidence interval for ADRs were alcohol intake, 1.7 (1.04, 2.80) and duration of hospital stay, 2.0 (1.16, 3.26). Conclusions Preventable ADRs are common and important cause of hospitalization and inpatients' morbidity and mortality among medical patients in Nigeria. Upper GI bleeding and hypoglycaemia, resulting from NSAIDs and antidiabetic drugs were the most observed ADRs. Strategic planning for intensive follow up of ADRs in Nigeria is advocated.

“…There are various systems and definitions of illness to code for, and variation in the granularity of coding systems creates difficulty comparing results. 13 Nevertheless, worldwide, there are numerous dermatology studies of the characteristics and case mix of inpatients, 14,15 inpatient consults [16][17][18][19][20][21][22][23][24] and emergency patients. [25][26][27][28] The focus of these studies is on assessing disease case mix by variables such as age, sex and season.…”

Section: Case MIXmentioning

confidence: 99%

“…Nevertheless, worldwide, there are numerous dermatology studies of the characteristics and case mix of inpatients, 14,15 inpatient consults 16–24 and emergency patients 25–28 . The focus of these studies is on assessing disease case mix by variables such as age, sex and season.…”

Section: Introductionmentioning

confidence: 99%

An Australian tertiary hospital analysis of outpatient dermatology clinical and demographic characteristics

et al. 2021

Objectives Literature on dermatology outpatient demographic and clinical data is limited, and the few studies on this topic are mainly conducted overseas, with medical systems and case mix different to Australia. This study presents demographic data relating to dermatology public outpatient referrals to a tertiary hospital in Brisbane, Australia, and determines what additional structured data should be collected to formulate and evaluate initiatives to address service issues such as referral quality, triage process and wait times. Methods A four‐year retrospective audit was undertaken, summarising all referrals (n = 7140) and clinical dermatology encounters (n = 53 844) between January 2016 and December 2019 at Princess Alexandra Hospital (PAH), the largest hospital in Metro South Health (MSH), serving a population of one million. PAH has one of the two largest public dermatology clinics in Queensland and is the only dermatology service within MSH. Results Patient demographic data, wait time by triage category, referral rates over time and encounter durations were collected. Structured diagnostic data (e.g. ICD‐10 coding) of the provisional diagnosis, comorbidities, medications and the final diagnosis are not collected in a structured format and would be a valuable addition. Conclusions The clinical burden of public dermatology is increasing. Both collection and analysis of structured data pertaining to the referrals and encounters are important to help formulate, implement and evaluate initiatives that aim to improve health service provision in this area.