Adverse drug reaction-related hospitalisations among patients with heart failure at two hospitals in the United Arab Emirates

Sharif-Askari, Narjes Saheb; Sulaiman, Syed Azhar Syed; Sharif-Askari, Fatemeh Saheb; Hussain, Ali Al Sayed

doi:10.1007/s11096-014-0046-3

Cited by 9 publications

(10 citation statements)

References 45 publications

(48 reference statements)

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“…The majority of preventable HF hospitalizations, deaths and increased health care cost are due to poor adherence to the use of approved evidence-based medications [ 24 ]. It has been reported that about 17% of HF patients may experience adverse effects of their medication and ADR-related hospitalizations account for 6.7% of admissions of HF patients to cardiac units [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Drug therapy problems and contributing factors in the management of heart failure patients in Jimma University Specialized Hospital, Southwest Ethiopia

et al. 2018

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BackgroundDrug therapy problem (DTP) is any unwanted incident related to medication therapy that actually or potentially affects the desired goals of treatment. Heart failure (HF) patients are more likely to experience DTP owing to multiple prescriptions and comorbidities. Despite the serious negative impact of DTP on treatment outcomes, there is a dearth of study on DTP among HF patients in Ethiopia.ObjectiveThe main aim of this study was to assess the prevalence and contributing factors of DTP among ambulatory HF patients in Jimma University Specialized Hospital, Ethiopia.MethodsA hospital based prospective observational study was conducted. Written informed consent was obtained from each patient after full explanation of the study. Data were collected through patient interview and expert review of medical, medication and laboratory records of one-year follow-up from May 2015 to April 2016. DTPs were identified using Cipolle’s method followed by consensus review with experts. Binary logistic regression was performed to identify factors contributing to DTP. A p<0.05 was considered statistically significant in all analyses.ResultOf 340 study participants; male to female ratio was equivalent, the mean (± SD = standard deviation) age was 50.5±15.6 years. Eight hundred eighty DTPs were identified equating 2.6 ±1.8 DTPs per patient. The frequently identified DTPs were dosage too low (27.8%), ineffective drug therapy (27.6%) and need additional drug therapy (27.4%). Most commonly implicated drugs were beta-blockers (34.4%), angiotensin converting enzyme inhibitors (24.8%), statins (16.5%) and antithrombotics (13.1%). Factors contributing to DTP were age >50 years (AOR [adjusted odd ratio] = 5.43, 95%CI [95% confidence interval] = 2.03–14.50); negative medication belief (AOR = 3.50, 95%CI = 1.22–10.05); poor involvement of patients in the therapeutic decision makings (AOR = 4.11, 95%CI = 1.91–8.88); number of co-morbidity≥2(AOR = 5.26, 95%CI = 2.38–11.65) and number of medications ≥5 (AOR = 3.68, 95%CI = 1.28–10.51).ConclusionDTPs are common among ambulatory care HF patients. Patients with older age, negative medication belief, polypharmacy, co-morbidities and those who were poorly involved in the therapeutic decision were more likely to experience DTP. Despite traditional prescription refilling, an integrated multidisciplinary approach involving patients and clinically trained pharmacists should be implemented in the patient care process at ambulatory care clinics in order to improve overall outcomes and reduce DTPs and associated burdens in HF patients.

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Section: Introductionmentioning

confidence: 99%

Drug therapy problems and contributing factors in the management of heart failure patients in Jimma University Specialized Hospital, Southwest Ethiopia

et al. 2018

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“… 33 , 34 Antithrombotics are frequently prescribed to older people and patients with cardiovascular problems, who are more prone to ADRs. 35 The risk of major cardiovascular events like cerebrovascular accidents and myocardial infarctions is related to many factors that are also risk factors for dementia, including age and cardiovascular disease. 36 Antithrombotics such as aspirin are prescribed to people with dementia for reducing the risks of major cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

Ten-year trends in adverse drug reaction–related hospitalizations among people with dementia

Zaidi

Peterson

Bereznicki

et al. 2022

Therapeutic Advances in Drug Safety

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Aim: Trends in the incidence of adverse drug reaction (ADR)–related hospitalizations have been studied in the general population, but not specifically in people with dementia. This study aimed to investigate trends in the incidence of ADR-related hospitalizations among people with dementia, and identify the most commonly implicated drugs and diagnoses in these admissions. Methods: This study utilized the administrative data of all adults admitted to the four major public hospitals of Tasmania, Australia, with a primary or secondary diagnosis of dementia from July 2010 to December 2019. ADR-related hospitalizations were identified by using diagnosis-based and external cause codes. The Cochran–Armitage test was used to examine trends in the incidence of ADR-related hospitalizations. Results: Of the 7552 people with dementia admitted to the hospital at least once within the study period, 1775 (23.5%) experienced at least one ADR-related hospitalization. The estimated annual incidence of ADR-related hospitalizations increased 18% (1484–1760 per 100,000 population with dementia, p for trend <0.05) from 2010 to 2019. For those ADR-related admissions with a drug code recorded, 19.3% were due to antithrombotics and 11.5% to antihypertensives. The most frequent ADR-related admission diagnoses were renal diseases (72.9%). Length of hospital stay and in-hospital mortality were both significantly greater for ADR-related, relative to non-ADR-related, admissions (median 7 versus 5 days and 11% versus 6.7%, respectively; p < 0.001). Conclusion: The annual incidence of ADR-related hospitalizations in people with dementia increased between 2010 and 2019. Antithrombotics were the most commonly implicated drug class. The ADR-related hospitalizations were associated with increased length of stay and greater mortality. Plain Language Summary Adverse drug reaction–related hospitalizations among people with dementia Introduction: This study aimed to investigate trends in hospitalizations associated with medication problems among people with dementia, and identify the most commonly implicated drugs and diagnoses in these admissions. Methods: This study utilized the administrative data of all adults admitted to the four major public hospitals of Tasmania, Australia, with dementia from July 2010 to December 2019. Results: The annual incidence of hospitalizations associated with medication problems among people with dementia increased nearly 20% over 10 years. The length of hospital stay and in-hospital mortality were significantly greater for hospitalizations related to medication problems. Conclusion: The incidence of hospitalizations associated with medication problems in people with dementia increased between 2010 and 2019.

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“…The prospective method identified more cardiovascular ADRs (mainly caused by diuretics and renin‐angiotensin system inhibitors), largely hypotension/orthostatic hypotension/syncope, than the administrative coding method. In another study involving prospective chart review by clinical pharmacists in heart failure patients, the most frequent drugs causing ADR‐related hospital admissions were diuretics and non‐steroidal anti‐inflammatory drugs causing electrolyte disturbances and heart failure exacerbation, respectively …”

Section: Discussionmentioning

confidence: 99%

Prospective identification versus administrative coding of adverse drug reaction‐related hospitalizations in the elderly: A comparative analysis

Nair

Chalmers

Peterson

et al. 2018

Pharmacoepidemiology and Drug

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Purpose To compare prospective identification of adverse drug reaction (ADR)‐related hospital admissions in the elderly with administrative coding using the International Classification of Diseases 10th Revision Australian Modification (ICD‐10‐AM) coding system. Methods We linked the records of 768 enrolled patients from an earlier study, where clinical pharmacists identified ADRs using prospective data collection, to hospital administrative data. We identified patients in the study whose admissions were coded as ADRs using ICD‐10‐AM codes. We then compared the prevalence and characteristics of ADR‐related hospital admissions identified by the two approaches. Results According to ICD‐10‐AM coding, 2.7% of patients were admitted due to ADRs, while 15.0% of patients were deemed to have been admitted due to ADRs based on prospective identification by clinical pharmacists. Most (85.7%) patients coded as having an ADR‐related hospital admission were also identified as such prospectively. Hematological (23.1%) and metabolic reactions (23.1%) were frequent causes of ADRs identified by coding, whereas cardiovascular ADRs (27.8%) were more common causes of ADRs identified prospectively by pharmacists. Antidepressants (16.7%) and cardiac glycosides (16.7%) were the most commonly implicated drug groups in ADRs identified by coding, whereas diuretics (28.8%) and renin‐angiotensin system inhibitors (17.0%) were frequently implicated as causes of ADRs identified prospectively by pharmacists. Conclusions Reliance on administrative coding potentially underestimates the extent of the problem of ADRs as a cause of hospitalization in the elderly, and more detailed prospective analysis of admissions provides additional targets for strategies to prevent ADRs. The types of ADRs identified also differ between the two approaches.

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Adverse drug reaction-related hospitalisations among patients with heart failure at two hospitals in the United Arab Emirates

Cited by 9 publications

References 45 publications

Drug therapy problems and contributing factors in the management of heart failure patients in Jimma University Specialized Hospital, Southwest Ethiopia

Drug therapy problems and contributing factors in the management of heart failure patients in Jimma University Specialized Hospital, Southwest Ethiopia

Ten-year trends in adverse drug reaction–related hospitalizations among people with dementia

Prospective identification versus administrative coding of adverse drug reaction‐related hospitalizations in the elderly: A comparative analysis

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