Adverse drug reactions (ADRs) are now recognized as an important cause of hospital admissions, with a proportion ranging from 0.9–7.9%. They also constitute a significant economic burden. We thus aimed at determining the prevalence and the economic burden of ADRs presenting to Medical Emergency Department (ED) of a tertiary referral center in India A prospective, observational study of adult patients carried out over a 6 week period in 2005. The prevalence of ADRs, their economic burden from the hospital perspective, severity, and preventability were assessed using standard criteria. A total 6899 patients presented during the study period. Of these, 2046 were admitted for various reasons. A total of 265/6899 patients had ADRs (3.84 %). A total of 141/265 was admitted due to ADsR, and thus ADRs as a cause of admissions were 6.89% of total admissions. A majority (74.71%) were found to be of moderate severity. The most common ADRs were anti-tubercular drug induced hepatotoxicity, warfarin toxicity and chloroquine induced gastritis. The median duration of hospitalization was 5 days [95% CI 5.37, 7.11], and the average hospitalization cost incurred per patient was INR 6197/- (USD 150). Of total ADRs, 59.62% (158/265) were found to be either definitely or potentially avoidable. The study shows that ADRs leading to hospitalization are frequent and constitute a significant economic burden. Training of patients and prescribers may lead to a reduction in hospitalization due to avoidable ADRs and thus lessen their economic burden.

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Evaluation of the prevalence and economic burden of adverse drug reactions presenting to the medical emergency department of a tertiary referral centre: a prospective study.

Objectives The frequency and the severity of drugrelated visits in emergency department (ED) make the improvement of adverse drug event (ADE) recognition a crucial issue. As part of a research project aiming to improve the diagnosis and the management of ADEs in ED, the authors conducted a pilot study whose primary objective was to assess ADE recognition by emergency physicians. Methods The patients presenting to the ED were included at randomised time periods between 1 October 2007 and 31 March 2008 in this prospective cross-sectional study. The primary outcome was the frequency of ADEs that were attributed to a medicationrelated problem by the emergency physician. Results A total of 423 patients met the inclusion criteria, of which 95 experienced an ADE (22.5%; 95% CI 18.6% to 26.7%). Emergency physicians correctly attributed 33 of these cases (34.7%; 95% CI 25.3% to 45.2%) to a medication-related problem. Of the 28 cases in which the ADE was considered as a ‘direct drug effect’ (29.5%; 95% CI 20.6% to 39.7%), 16 were correctly identified by emergency physicians (57.1%; 95% CI 37.2% to 75.5%). Of the 67 cases in which the ADE was considered as a ‘drug involvement in a multifactorial pathological condition’ (70.5%; 95% CI 60.3% to 79.4%), 17 were correctly attributed (25.4%; 95% CI 15.5% to 37.5%). Conclusions ADEs are frequent in EDs and are not well recognised by emergency physicians, especially when the drug is involved in a multifactorial pathological condition.

https://emj.bmj.com/content/emermed/early/2012/02/24/emermed-2011-200482.full.pdf

Assessment of adverse drug event recognition by emergency physicians in a French teaching hospital

https://revistafarmaciahospitalaria.sefh.es/gdcr/index.php/fh/article/download/819/819

Resultados negativos asociados con la medicación en un servicio de urgencias hospitalario

ADR is an important public health problem which reduces quality of care patients receive and increases cost to healthcare system. Little is known about the incidence and economic burden of ADR-related ED visits and subsequent hospitalizations in Canada. This study estimated the incidence and cost of ADR-related ED visits and subsequent hospitalizations for patients (>65 years) in Ontario, and explored patient, drug and system factors associated with severe ADRs. In a population-based retrospective cohort of Ontario older adults, 7222 (0.75%) of all ED visits were ADR-related, and among these patients 21.56% were hospitalized in 2007; In 2007, the total measured cost of ADR-related visits and subsequent hospitalizations amounted to $13.6 million with the cost being $333.47 and $7528.64 per person for ED visits and subsequent hospitalizations, respectively. Severe ADRs were associated with sex, age, comorbidity, multiple drugs, multiple pharmacies, newly prescribed drugs, recent ED visit, recent hospitalization and LTC residents.%%%%MAST

Adverse Drug Reactions in the Emergency Department Population in Ontario: Analysis of National Ambulatory Care Reporting System and Discharge Abstract Database 2003-2007

Negative results associated with medication in the emergency department of a hospital

https://revistafarmaciahospitalaria.sefh.es/gdcr/index.php/fh/article/download/1039/1039

S. Prieto Moix

Papers

Detección y análisis de reacciones adversas a medicamentos en el servicio de urgencias de un hospital general