Adverse drug reaction‐related hospitalisations: a population‐based cohort study
Pharmacoepidemiology and Drug SafetyPublished 27 February 2008
C Hooft, Jeanne P. Dieleman, Claire Siemes, Albert‐Jan L.H.J. Aarnoudse, Katia Verhamme, Bruno H. Stricker
Citations180
SJR quartileQ1
SJR score1.02
SNIP0.98
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TL;DR
To evaluate the extent, characteristics and determinants of adverse drug reaction (ADR)‐related hospitalisations on a population‐based level in 2003, a large number of patients were admitted to hospital with suspected ADR‐related illnesses.
Abstract
PURPOSE: To evaluate the extent, characteristics and determinants of adverse drug reaction (ADR)-related hospitalisations on a population-based level in 2003. METHODS: We performed a cohort study in the Integrated Primary Care Information (IPCI) database, a general practitioners (GPs) research database with longitudinal data from electronic patient records of a group of 150 GP throughout the Netherlands. Hospital discharge letters and patient records were reviewed to evaluate ADR-related hospitalisations applying WHO causality criteria. The prevalence of ADR-related hospitalisations per total admissions and the incidence per drug group were calculated. Avoidability and seriousness of the ADRs causing admission were assessed applying the algorithm from Hallas. RESULTS: We identified 3515 hospital admissions, 1277 elective and 2238 acute. Of the acute admissions, 115 were caused by an ADR giving a prevalence of 5.1% (95% confidence intervals (CI): 4.3-6.1%). The prevalence of ADR-related acute admissions increased with age up to 9.8% (95%CI: 7.5-12.7) for persons >75 years. The ADRs that most frequently caused hospitalisations were gastro-intestinal bleeding with anti-thrombotics, bradycardia/hypotension with cardiovascular drugs and neutropenic fever with cytostatics. The incidence rate of ADR-related hospitalisations per drug group was highest for anti-thrombotics and anti-infectives and was relatively low for cardiovascular drugs. Fatality as a direct consequence of the ADR-related admission was 0.31%. In elderly patients 40% of the ADRs causing hospitalisation were judged to be avoidable. CONCLUSIONS: The extent and potential avoidability of ADR-related hospitalisations is still substantial, especially in elderly patients. Measures need to be put into place to reduce the burden of ADRs.
Keywords
MedicineHealth ProfessionsPharmacology, Toxicology and Pharmaceutics
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