Risk Factors for Hospital Admissions Associated with Adverse Drug Events

Kongkaew, Chuenjid; Hann, Mark; Mandal, J; Williams, Steven; Metcalfe, David; Noyce, Peter; Ashcroft, Darren M.

doi:10.1002/phar.1287

Cited by 114 publications

(82 citation statements)

References 35 publications

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“…This finding was supported by previous results. 19 Our study results also revealed that oral hypoglycemics are the second categories of drugs that have caused ADR related hospital admission. Larger number of diabetic patients in our study population and poor awareness of patients with regard to hypoglycaemic symptoms might be plausible explanation for increased ADRs observed with oral hypoglycaemic drugs.…”

Section: Adverse Drug Reactionsmentioning

confidence: 56%

“…Similar to our findings, previous results demonstrate that 7.1% of hospital admissions result from DRPs, of which 59% were deemed preventable. 29,30 On the other hand, A Scottish paper, based on the same methodology, reported that only 13.3% of admissions were unavoidable. 31 Several other studies have reported similar findings with 60-70% of ADRs being classes as preventable.…”

Section: Preventabilitymentioning

confidence: 99%

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Incidence and Factors Associated with Drug Related Hospital Admissions in a South Indian Tertiary Care Hospital

Dammalapati¹,

Challa²,

Challa³

et al. 2018

IJOPP

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Objective:The study aimed to assess the incidence, nature of drug related hospital admissions (DRHAs) and factors associated with DRHAs. Method: A retrospective study was conducted to evaluate the medical records of patients admitted to general medicine department for six months. Drug related hospital admissions were assessed using Helper and Stand Classification. Crude odds ratio (COR) and adjusted odds ratio (AOR) were determined using univariate and multivariate logistic regression analysis. Results: The results of analysis of 1177 medical records reveal that 202 (17.2%) patients were admitted due to 248 DRHAs. Of which, the most common DRHA was non-compliance that accounted for 50.50% (102). Out of 248 drug related hospital admissions, 65.8% (n=163) were definitely preventable, 30.2% (n=75) were possibly preventable and 4.0% (n=10) were definitely not preventable. However, multivariate regression analysis results indicate that hypertension, diabetes mellitus, and polypharmacy at admission are significantly (p< 0.001) associated with DRHA. Conclusion: The factors remarkably associated with drug related hospital admissions are age, diabetes mellitus, hypertension and polypharmacy. The major reasons for drug related hospital admissions are non-compliance and adverse drug reactions. Collaborative efforts among patients, physicians, pharmacists and caregivers might reduce the frequency of drug related hospital admissions.

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Section: Adverse Drug Reactionsmentioning

confidence: 56%

Section: Preventabilitymentioning

confidence: 99%

Incidence and Factors Associated with Drug Related Hospital Admissions in a South Indian Tertiary Care Hospital

Dammalapati¹,

Challa²,

Challa³

et al. 2018

IJOPP

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show abstract

“…However, studies in inpatient settings demonstrate that 10% of patients are admitted to hospital due to adverse drug events and approximately 5% of these are preventable medicines-related issues 4. Furthermore, medication errors are one of the leading causes of injury to hospital patients, and medication chart reviews reveal that over half of all hospital medication errors occur at the interfaces of care 12.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, a significant number of medicines-related incidents occur when patients transfer between care settings 2. The literature suggests that 6%–10% of admissions have a medicines-related contribution due to adverse drug events 3 4. Hospitals in the UK are expected to comply with relevant standards5 and guidance 2.…”

Section: Introductionmentioning

confidence: 99%

Medicines reconciliation pilot at transfer of care: admission to a community-based early supported discharge (‘step-down’) and prevention of admission (‘step-up’) service

et al. 2016

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IntroductionEarly supported discharge (‘step-down’) and prevention of admission (‘step-up’) services require safe medicines reconciliation. Medication discrepancies at transfer of care are a potential cause of patient harm. There is currently no published work examining level of medication discrepancies and associated risk in this setting.ObjectivesWorking within a ‘step-up’ and ‘step-down’ integrated service based in the community, caring for patients in their home to:▸ quantify the number of medicines discrepancies and allergy status discrepancies▸ ascertain the type of discrepancies▸ assess the potential for harm caused by these discrepancies.MethodsMedicines reconciliation was performed by two pharmacists for patients within the ‘step-up’ and ‘step-down’ service as well as patients recently discharged from hospital to a care home. The resulting medication history was compared with the original medication history documented in the service's notes. Allergy status and medication discrepancies were identified and the type of discrepancy was recorded. National Patient Safety Agency (NPSA) risk assessment was used to categorise the level of risk of each discrepancy.Results20 out of the 54 patients (37%) did not have an allergy status recorded at baseline. Of the 573 medications listed for patients reviewed following medicines reconciliation, 317 (55%) had a medication discrepancy. There was an average of 5.87 (95% CI 4.53 to 7.18) medication discrepancies per patient of which 49% were classified (NPSA) as moderate, high or extreme risk.ConclusionsThere was a high level of medication discrepancies in this service with implications for patient safety and cost. Such services would benefit from pharmacist-led medicines reconciliation.

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“…Several studies have shown that antiplatelet, anticoagulants, diuretics, and NSAIDs (non-steroidal anti-inflammatory drugs) are responsible for more than half of the preventable drug-related admissions to hospital [13,14]. Elderly patients also have a high risk of drug-related problems, such as delirium or renal failure, with an increasing number of medications [15].…”

Section: Introductionmentioning

confidence: 99%

Practical Experience with Anticoagulation Therapy in an Elderly Polymorbid Rehabilitation Population: What did we Learn?

Schmidt¹,

Angst²,

Gantenbein³

et al. 2016

J Gerontol Geriatr Res

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Objective: The aim of this cross-sectional study was to analyze the prescription patterns of oral anticoagulation and antiplatelet therapy in an elderly population in rehabilitation hospitals.Methods: 200 patients, after undergoing knee/hip surgery or after a stroke, were evaluated over a time span of one year.Results: All patients necessitated anticoagulation; the average number of medications taken was 8. The most frequent combination was the new oral anticoagulation with antiplatelet agents. 35% of the patients on this combination therapy did not receive proton pump inhibitors. Conclusion:The increased use of the new oral anticoagulation medicine increases the frequency of dual therapy. Careful and repetitive investigation of indications, benefits and negative side-effects should be considered in order to reduce complications.

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Risk Factors for Hospital Admissions Associated with Adverse Drug Events

Cited by 114 publications

References 35 publications

Incidence and Factors Associated with Drug Related Hospital Admissions in a South Indian Tertiary Care Hospital

Incidence and Factors Associated with Drug Related Hospital Admissions in a South Indian Tertiary Care Hospital

Medicines reconciliation pilot at transfer of care: admission to a community-based early supported discharge (‘step-down’) and prevention of admission (‘step-up’) service

Practical Experience with Anticoagulation Therapy in an Elderly Polymorbid Rehabilitation Population: What did we Learn?

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