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Adverse-drug-reaction related admissions to a hospital in Scotland

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Abstract

Aims To apply established methods to identify ADR-related admissions and to determine the proportion which was preventable and which were caused by non-prescription medicines (NPMs). Methods This prospective, observational study screened all acute hospital admissions (n = 1,101) by ward pharmacists over a 2-week period. Suspected ADR-related admissions were reported to the researcher and established criteria were used to evaluate probability, causality and preventability of the ADR-related admissions. Results Of the 1,101 emergency admissions which occurred during the study period, 30 were categorised as ADR-related, equating to a prevalence of 2.7% (95% CI, 1.8–3.7%). Three (9.7%) of the 30 admissions were associated with NPMs. The ADR was the dominant reason for admission in 56.7% (n = 17/30) and only 13.3% (n = 4/30) of all reported admissions were assessed as unavoidable. Conclusion The proportion of ADR-related admissions was lower than in previous studies in the UK. A substantial proportion of ADRs was associated with NPMs, highlighting the need for greater awareness amongst patients, prescribers and other health care professionals regarding possible serious adverse effects caused by these medicines.

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References

  1. WHO. Safety of medicines – a guide to detecting and reporting adverse drug reactions. 2002.

  2. Pirmohamed M, Breckenridge AM, Kitteringham NR, Park BK. Forthnightly review: adverse drug reactions. BMJ. 1998;316:1295–8.

    PubMed  CAS  Google Scholar 

  3. Muehlberger N, Schneeweiss S, Harford J. Adverse drug reaction monitoring – cost and benefit considerations. Part 1: frequency of adverse drug reactions causing hospital admissions. Pharmacoepidemiol Drug Saf. 1997;6(3):S71–7.

    Article  PubMed  Google Scholar 

  4. Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18,820 patients. BMJ. 2004;329:15–9. doi:10.1136/bmj.329.7456.15.

    Article  PubMed  Google Scholar 

  5. Hitchen L. Adverse drug reactions result in 250,000 UK admissions per year. BMJ. 2006;332:1109. doi:10.1136/bmj.332.7550.1109.

    Article  PubMed  Google Scholar 

  6. Green CF, Mottram DR, Howe PH, Pirmohamed M. Adverse drug reactions as a cause of admission to an acute medical assessment unit: a pilot study. J Clin Pharm Ther. 2000;25:355–61. doi:10.1046/j.1365-2710.2000.00298.x.

    Article  PubMed  CAS  Google Scholar 

  7. Howard RL, Avery AJ, Howard PD, Partridge M. Investigation into the reasons for preventable drug related admissions to a medical admissions unit: observational study. Qual Saf Health Care. 2003;12:280–5. doi:10.1136/qhc.12.4.280.

    Article  PubMed  CAS  Google Scholar 

  8. Hussain RM. Case report: the sweet cake that reaches parts other cakes can’t!. Postgrad Med J. 2003;79:115–6. doi:10.1136/pmj.79.928.115.

    Article  PubMed  CAS  Google Scholar 

  9. Ferner RE, Aronson JK. National differences in publishing papers on adverse drug reactions. Br J Clin Pharmacol. 2005;59(1):108. doi:10.1111/j.1365-2125.2005.02267.x.

    Article  PubMed  CAS  Google Scholar 

  10. Waller P, Shaw M, Ho D, Shakir S, Ebrahim S. Hospital admissions for ‘drug-induced’ disorders in England: a study using the Hospital Episodes Statistics (HES) database. Br J Clin Pharmacol. 2005;59(2):213. doi:10.1111/j.1365-2125.2004.02236.x.

    Article  PubMed  Google Scholar 

  11. Williams D, Feely J. Underreporting of adverse drug reactions: attitudes of Irish doctors. Ir J Med Sci. 1999;168:257–61.

    PubMed  CAS  Google Scholar 

  12. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239–45.

    PubMed  CAS  Google Scholar 

  13. Rawlins MD, Thomas SHL. Mechanisms of adverse drug reactions. In: Davies DM, Ferner RE, de Glanville H, editors. Davies’s textbook of adverse drug reactions. 5th ed. Philadelphia: Lippincott-Raven Publishers; 1998. ISBN 0412824809.

  14. Hallas J, Harvald B, Gram LF, Grodum E, Brosen K, Haghfelt T, et al. Drug related hospital admissions: the role of definitions and intensity of data collection and the preventability of prevention. J Intern Med. 1990;228:83–90.

    Article  PubMed  CAS  Google Scholar 

  15. Wilson EB. Probable inference, the law of succession, and statistical inference. J Am Stat Assoc. 1927;22:209–12. doi:10.2307/2276774.

    Article  Google Scholar 

  16. Bhalla N, Duggan C, Dhillon S. The incidence and nature of drug-related admissions to hospital. Pharm J. 2003;270:583–6.

    Google Scholar 

  17. Ang-Lee MK, Moss J, Yuan C. Herbal medicines and perioperative care. JAMA. 2001;286(2):208–16. doi:10.1001/jama.286.2.208.

    Article  PubMed  CAS  Google Scholar 

  18. Carden SM, Good WV, Good RM. Case report – garlic and the strabismus surgeon. Clin Experiment Ophthalmol. 2002;30:303–4. doi:10.1046/j.1442-9071.2002.00540.x.

    Article  PubMed  Google Scholar 

  19. Committee on Safety of Medicines. Annual report (2002), NHS Scotland Edinburgh.

  20. Teweleit S, Kuschel U, Hippius M, Goettler M, Bornschein B. Manifestation and possible prevention of adverse drug reactions (ADR) in pharmacotherapy of cardiovascular diseases. Med Klin. 2001;96(8):442–50. Manifestation and Praeventationsmoeglichkeiten unerwuenschter Arzneimittelwirkungen (UAW) in der Pharmakotherapie von Herz-Kreislauf-Erkrankungen. doi:10.1007/PL00002226.

    Google Scholar 

  21. Seymour RM, Routledge PA. Important drug-drug interactions in the elderly. Drugs Aging. 1998;12(6):485. doi:10.2165/00002512-199812060-00006.

    Article  PubMed  CAS  Google Scholar 

  22. Rozich JD, Haraden CR, Resar RK. Adverse drug event trigger tool: a practical methodology for measuring medication related harm. Qual Saf Health Care. 2003;12:194–200. doi:10.1136/qhc.12.3.194.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

We thank the ward pharmacists at Aberdeen Royal Infirmary for screening the admissions as well as Shona Fielding and John Townend for their statistical support.

Funding

Yvonne Hopf was supported by the Clinical Pharmacology Programme Scholarship at University of Aberdeen.

Conflicts of interest

None.

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Correspondence to David Williams.

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Hopf, Y., Watson, M. & Williams, D. Adverse-drug-reaction related admissions to a hospital in Scotland. Pharm World Sci 30, 854–862 (2008). https://doi.org/10.1007/s11096-008-9240-5

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