Pharmacy World & Science

, 30:854 | Cite as

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

Research Article

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.

Keywords

Adverse drug reaction Hospital admission Non-prescription drug OTC medicines Prescription medicines Scotland 

References

  1. 1.
    WHO. Safety of medicines – a guide to detecting and reporting adverse drug reactions. 2002.Google Scholar
  2. 2.
    Pirmohamed M, Breckenridge AM, Kitteringham NR, Park BK. Forthnightly review: adverse drug reactions. BMJ. 1998;316:1295–8.PubMedGoogle Scholar
  3. 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.PubMedCrossRefGoogle Scholar
  4. 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.PubMedCrossRefGoogle Scholar
  5. 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.PubMedCrossRefGoogle Scholar
  6. 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.PubMedCrossRefGoogle Scholar
  7. 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.PubMedCrossRefGoogle Scholar
  8. 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.PubMedCrossRefGoogle Scholar
  9. 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.PubMedCrossRefGoogle Scholar
  10. 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.PubMedCrossRefGoogle Scholar
  11. 11.
    Williams D, Feely J. Underreporting of adverse drug reactions: attitudes of Irish doctors. Ir J Med Sci. 1999;168:257–61.PubMedGoogle Scholar
  12. 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.PubMedGoogle Scholar
  13. 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.Google Scholar
  14. 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.PubMedCrossRefGoogle Scholar
  15. 15.
    Wilson EB. Probable inference, the law of succession, and statistical inference. J Am Stat Assoc. 1927;22:209–12. doi:10.2307/2276774.CrossRefGoogle Scholar
  16. 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. 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.PubMedCrossRefGoogle Scholar
  18. 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.PubMedCrossRefGoogle Scholar
  19. 19.
    Committee on Safety of Medicines. Annual report (2002), NHS Scotland Edinburgh.Google Scholar
  20. 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. 21.
    Seymour RM, Routledge PA. Important drug-drug interactions in the elderly. Drugs Aging. 1998;12(6):485. doi:10.2165/00002512-199812060-00006.PubMedCrossRefGoogle Scholar
  22. 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.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  1. 1.Department of PharmacyAberdeen Royal InfirmaryForesterhill, AberdeenScotland, UK
  2. 2.Department of General Practice and Primary CareUniversity of AberdeenAberdeenScotland, UK
  3. 3.Department of Clinical PharmacologyAberdeen Royal InfirmaryForesterhill, AberdeenScotland, UK

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