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Postdischarge Adverse Drug Reactions in Primary Care Originating from Hospital Care in France

A Nationwide Prospective Study

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Abstract

Objective: To describe and estimate the incidence and preventability of postdischarge adverse drug reactions (ADRs) detected in primary care in France.

Design: Prospective study of patients referred to hospital by participating general practitioners (GPs). These GPs reported all cases of an adverse reaction to a drug instituted in hospital among patients who consulted them within 30 days of discharge.

Setting: 305 general practices from all French regions.

Patients: 7540 patients referred by GPs to private or public hospitals.

Main outcome measures: The incidence for postdischarge ADRs in primary care, and their preventability.

Results: 30 cases of postdischarge ADR were detected in 29 re-consulting patients, yielding a minimal incidence for France of 0.4 per 100 admissions (95% confidence interval 0.3 to 0.6). The ADRs were assessed as serious in 60% of cases. The main drug classes implicated were cardiovascular drugs (8 ADRs), oral anticoagulants (6), psychoactive drugs (4), antidiabetics (3), and opioid analgesics (3). Patients experiencing a postdischarge ADR were older than patients not experiencing one (median age: 77 vs 68 years; p = 0.004). Detected ADRs were considered preventable in 59% of cases.

Conclusions: Physicians and patients should be aware of the possible occurrence of postdischarge ADRs. Patient information in hospital, close postdischarge follow-up of patients at risk, and appropriate transmission of information between hospital physicians and GPs can help to prevent them.

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Acknowledgments

We would like to thank the general practitioners who participated in this survey; and Jean-Christophe Rousseau, Associate Director of La Rochelle Hospital, for his help in the data monitoring process.

The study was supported by a research grant from the Institut National de la Sante et de la Recherche Medicale (INSERM).

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Authors and Affiliations

  1. INSERM Unit 444, WHO Collaborating Centre for Electronic Disease Surveillance, National Institute for Health and Medical Research (INSERM), Université Paris 6, 27 rue Chaligny 75571 Paris CEDEX 12, Paris, France

    Laurent Letrilliart, Jean-Paul Fagot, Marguerite Guiguet &  Antoine Flahault

  2. Department of Internal Medicine, Ambroise-Paré Hospital, Boulogne-Billancourt, and Université Paris 5, Paris, France

    Thomas Hanslik

  3. Regional Centre for Pharmacovigilance and Drug Information, Saint-Antoine Hospital, Paris, France

    Michel Biour

Authors
  1. Laurent Letrilliart
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  2. Thomas Hanslik
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  4. Jean-Paul Fagot
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  6. Antoine Flahault
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Correspondence to Antoine Flahault.

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Letrilliart, L., Hanslik, T., Biour, M. et al. Postdischarge Adverse Drug Reactions in Primary Care Originating from Hospital Care in France. Drug-Safety 24, 781–792 (2001). https://doi.org/10.2165/00002018-200124100-00006

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