Adverse drug events in two emergency departments in Naples, Italy: an observational study

Capuano, Annalisa; Motola, Giulia; Russo, Francesco Paolo; Avolio, Amalia; Filippelli, Amelia; Rossi, Francesco; Mazzeo, Filomena

doi:10.1016/j.phrs.2004.05.008

Cited by 46 publications

(33 citation statements)

References 18 publications

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“…Although there is considerable variability between the frequencies reported in previous prospective studies of unplanned 25 or ED admissions (range 2.4-30.4%), 6,8,9,[12][13][14][15] the mean rate of ADE-RAs is 9.2%, which is comparable to the findings of the present study. If we were to remove an Australian study, which was restricted to ADE-RAs in elderly patients, 9 the mean frequency is reduced to 5.7%, much lower than our reported figure.…”

Section: Discussionsupporting

confidence: 86%

“…Capuano et al, 8 Chan et al, 9 Dartnell et al 6 and Malhotra et al 12 reported that 8.9%, 61.4%, 62.0% and 14.4%, respectively, of ADEs investigated had a likelihood of at least 'probable'. These authors used different classifications, which could account for the wide variation in the reported likelihood of causality.…”

Section: Discussionmentioning

confidence: 99%

“…Because previous studies did not follow a standardised code to group drugs, it is difficult to make comparisons as to which drugs cause ADE-RAs; however, cardiovascular drugs are consistently reported as being major contributors. 6,[8][9][10][11][12][13]30 In addition, antiinflammatory, antithrombotic, anti-infective and antidiabetic agents are commonly implicated in other studies. 6,[8][9][10][11][12][13] A major limitation of the present study was the use of Jones' algorithm, 26 which proved to be unsuitable for assessing the causality of ADEs that were not ADRs.…”

Section: Discussionmentioning

confidence: 99%

“…6,8,[12][13][14][15] Further, more than one-quarter of ADE-RA cases were associated with at least one ADE classified as causing moderate or severe harm, assessed as 'definitely avoidable' and classified with a likelihood of causality as probable or highly probable, which amounts to more than one in 25 of all admissions being serious and preventable. The findings of the present study support implementing a systems approach involving multiple strategies not only to detect ADE-RAs earlier in the admission, thus potentially reducing patient morbidity and length of stay, but also to tackle the problem of avoidable ADE-RAs and the associated cost burden.…”

Section: Discussionmentioning

confidence: 99%

“…A review of the international literature shows the frequency of ADE-RAs being 1.4-30.4% when determined prospectively. 6,[8][9][10][11][12][13][14][15] When Capuano et al, 8 Chan et al , 9 Dartnell et al 6 and Malhotra et al 12 examined causality between drug and ADE, they found that events were either 'definitely' or 'probably' due to drugs in 8.9%, 61.4%, 62.0% and 27.7% of cases, respectively. Each study used a different method to determine causality: Capuano et al 6 used the Naranjo Algorithm, 16 which is commonly used to assess causality of ADRs, Dartnell et al 6 used criteria modified from Karch and Lasagna, 17 whereas Chan et al 7 and Malhotra et al 10 defined their own criteria for causality.…”

Section: Introductionmentioning

confidence: 99%

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Hospital admissions caused by adverse drug events: an Australian prospective study

Phillips¹,

Nigro²,

Macolino³

et al. 2014

Aust. Health Review

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Objective. To assess the frequency of adverse drug event (ADE)-related admissions (ADE-RAs) during a prospective medical record review of patients admitted to a metropolitan tertiary referral hospital.Methods. Potential ADE-RA cases were identified by examination of case records of randomly selected patients. Cases were assessed by an expert panel to measure study outcomes, which were the frequency (ADEs and ADE-RAs) as well as type, likelihood of causality, severity, avoidability and detection of ADEs.Results. Of the 370 subjects, 59 (16.0%) had a confirmed ADE-RA, with 15 (4.1%) of these serious and preventable. The 59 ADE-RAs were a result of 72 discreet ADEs. Adverse drug reactions were the most common type of ADE, followed by non-compliance. Of the 72 discreet ADEs, 31.9% were classified as 'probable' or 'highly probable'. Most ADEs (54.2%) were classified as 'definitely avoidable', 34.7% were classified as 'severe' and 21.8% were classified as both 'definitely avoidable' and 'severe'. Half the ADEs were detected after the patient had been admitted and most were detected by medical practitioners. Antineoplastics followed by antidiabetic agents were most frequently implicated.Conclusions. Implementing a systems approach that involves multiple strategies, such as improving tertiary-toprimary care information transfer and promoting medication adherence through education programs, is necessary to tackle the problem of avoidable ADE-RAs and the associated cost burden.What is known about the topic? It is estimated that 2-3% of Australian hospital admissions are due to adverse drug events (ADEs), but recent data are lacking. According to the Australian Statistics on Medicines, over 250 million prescriptions were dispensed in 2007, compared with just under 180 million in 1997. This 40% increase in drug utilisation over the 10 years surpasses the Australian population growth of 14% in the same period. An increase in drug use per person indicates that the rate of ADEs and possible ADE-related admissions (ADE-RAs) is likely to have increased. What does this paper add? This prospective study was conducted at a large Australian metropolitan teaching hospital and we report that 59 of 370 participants (16.0%) presenting to the Emergency Department had a confirmed ADE-RA, with 15 (4.1%) presenting with a serious and preventable ADE-RA. What are the implications for practitioners? The findings of this study support implementing a systems approach involving multiple strategies to tackle the problem of avoidable ADE-RAs and the associated cost burden. This study reveals that half the ADEs were not detected until after the admission process, which reinforces the importance of focusing efforts Journal compilation Ó AHHA 2014

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hospital admissions caused by adverse drug events: an Australian prospective study

Phillips¹,

Nigro²,

Macolino³

et al. 2014

Aust. Health Review

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Adverse drug reaction‐related hospitalisations: a population‐based cohort study

Hooft

Dieleman

Siemes

et al. 2008

Pharmacoepidemiology and Drug

133

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Risk Factors for Hospital Admissions Associated with Adverse Drug Events

et al. 2013

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Adverse drug events are an important cause of hospital admission. Better systems for health care practitioners to identify patients at high risk of preventable hospital admissions associated with ADEs (e.g., age > 65 years old, receiving more than five drugs, and starting new high-risk drugs) should be implemented in order to minimize the risks to patients and the burden on the health care system.

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Adverse drug events in two emergency departments in Naples, Italy: an observational study

Cited by 46 publications

References 18 publications

Hospital admissions caused by adverse drug events: an Australian prospective study

Hospital admissions caused by adverse drug events: an Australian prospective study

Adverse drug reaction‐related hospitalisations: a population‐based cohort study

Risk Factors for Hospital Admissions Associated with Adverse Drug Events

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