Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital

Fabiana Rossi Varallo, Helaine Carneiro Capucho, Cleópatra da Silva Planeta, Patrícia de Carvalho Mastroianni, Fabiana Rossi Varallo, Helaine Carneiro Capucho, Cleópatra da Silva Planeta, Patrícia de Carvalho Mastroianni

Abstract

Objectives: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions.

Method: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to December 2008. All patients aged ≥18 years with a length of stay ≥24 hours were interviewed about the drugs used prior to hospital admission and their symptoms/complaints/causes of hospitalization.

Results: In total, 248 patients were considered eligible. The prevalence of hospitalization due to potential adverse drug events in the ward was 46.4%. Overprescribed drugs and those indicated for prophylactic treatments were frequently associated with possible adverse drug events. Frequently reported symptoms were breathlessness (15.2%), fatigue (12.3%), and chest pain (9.0%). Polypharmacy was a risk factor for the occurrence of possible adverse drug events.

Conclusion: Possible adverse drug events led to hospitalization in a high-complexity hospital, mainly in polymedicated patients. The clinical outcomes of adverse drug events are nonspecific, which delays treatment, hinders causality analysis, and contributes to the underreporting of cases.

Conflict of interest statement

No potential conflict of interest was reported.

References

    1. Nebeker JR, Barach P, Samore MH. Clarifying adverse drug events: a clinician's guide to terminology, documentation and reporting. Ann Intern Med. 2004;140(10):795–801.
    1. Klopotowska JE, Wierenga PC, Smorenburg SM, Stuijt CC, Arisz L, Kuks PF, et al. Recognition of adverse drug events in older hospitalized medical patients. Eur J Clin Pharmacol. 2013;69(1):75–85.
    1. Leendertse AJ, Visser D, Egberts AC, van den Bemt PM. The relationship between study characteristics and the prevalence of medication-related hospitalizations: a literature review and novel analysis. Drug Saf. 2010;33(3):233–44.
    1. Leendertse AJ, Van Den Bemt PM, Poolman JB, Stoker LJ, Egberts AC, Postma MJ. Preventable hospital admissions related to medication (HARM): cost analysis of the HARM study. Value Health. 2011;14(1):34–40.
    1. Otero López MJ, Alonso Hernández P, Maderuelo Fernández JA, Ceruelo Bermejo J, Domínguez-Gil Hurlé A, Sánchez Rodríguez A. Prevalence and factors associated with preventable adverse drug events leading to hospital admission. Farm Hosp. 2006;30(3):161–167.
    1. Krähenbühl-Melcher A, Schlienger R, Lampert M, Haschke M, Drewe J, Krähenbühl S. Drug-related problems in hospitals: a review of the recent literature. Drug Saf. 2007;30(5):379–407.
    1. Kongkaew C, Hann M, Mandal J, Williams SD, Metcalfe D, Noyce PR, et al. Risk factors for hospital admissions associated with adverse drug events. Pharmacotherapy. 2013;33(8):827–37.
    1. Onder G, Pedone C, Landi F, Cesari M, Vedova CD, Bernabei R, et al. Adverse drug reactions as cause of hospital admissions: results from the Italian group of pharmacoepidemiolgogy in the elderly (GIFA) J Am Geriatr Soc. 2002;50(12):1962–8.
    1. Caamaño F, Pedone C, Zuccala G. Socio-Demographic factors related to the prevalence of adverse drug reaction at hospital admission in an elderly population. Arch Gerontol Geriatr. 2005;40(1):45–52.
    1. Mastroianni PC, Varallo FR, Barg MS, Noto NA, Galduróz JF. Contribuição do uso de medicamentos para a admissão hospitalar. Braz J Pharm Sci. 2009;45(1):163–70.
    1. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Robers EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239–45.
    1. Rollason V, Vogt N. Reduction of polypharmacy in the elderly: a systematic review of the role of the pharmacist. Drugs Aging. 2003;20(11):817–32.
    1. Moore N, Lecointre D, Noblet C, Mabille M. Frequency and cost of serious adverse drug reactions in a department of general medicine. Br J Clin Pharmacol. 1998;45(3):301–8.
    1. De Beradis G, Sacco M, Strippoli GFM, Pellegrini F, Graziano G, Tognoni G, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomized controlled trials. BMJ. 2009;339:b4531.
    1. 2013 Brasil Ministério da Saúde. Portaria n°. 529, de 01 de abril de 2013. Diário Oficial da União, Brasília, 02 de abril de.
    1. Alexopoulou A, Dourakis SP, Mantzoukis D, Pitsariotis T, Kandyli A, Deutsch M, et al. Adverse drug reactions as a cause of hospital admissions: A 6-month experience in a single center in Greece. Eur J Intern Med. 2008;19(7):505–10.
    1. Klotz U, Mörike K, Shi S. The clinical implications of aging for rational drug therapy. Eur J Clin Pharmacol. 2008;64(2):183–99.
    1. Varallo FR, Capucho HC, Planeta CS, Mastroianni CP. Safety assessment of potentially inappropriate medications (PIM) use in older people and the factors associated with hospital admission. J Pharm Pharm Sci. 2011;14(2):283–90.
    1. Kloner RA, Rezkalla SH. To drink or not to drink. That is the question. Circulation. 2007;116(11):1306–17.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere