Adverse Drug Reactions (ADR) and Emergencies

Schurig, A Marlen; Böhme, Miriam; Just, Katja S; Scholl, Catharina; Dormann, Harald; Plank-Kiegele, Bettina; Seufferlein, Thomas; Gräff, Ingo; Schwab, Matthias; Stingl, Julia C.

doi:10.3238/arztebl.2018.0251

Cited by 65 publications

(86 citation statements)

References 30 publications

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“…In a prospective analysis of emergency visits, we reported a frequency of 6.5 % of ADR as cause for the unplanned event [5], thereby confirming earlier data from others [6,7]. In this analysis, we wanted to shape out the role of psychotropic drug use in the general population with regard to severe safety issues that led to emergency visits.…”

Section: Discussionsupporting

confidence: 75%

“…In our previous analysis of unplanned emergency visits in 4 large hospitals in Germany, a frequency of 6.5 % ADRs as cause for the visit was identified [5]. Similar frequency numbers of ADR in emergency departments were detected in other countries [6,7] .…”

Section: Discussionsupporting

confidence: 51%

“…This analysis was done in n = 2215 ED cases of the ADRED cohort as has been described before [5]. Patients in 4 German tertiary care hospitals without psychiatric wards were enrolled.…”

Section: Cohort Descriptionmentioning

confidence: 99%

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Prevalence of Psychotropic Drugs in Cases of Severe Adverse Drug Reactions Leading to Unplanned Emergency Visits in General Hospitals

et al. 2020

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Introduction The prevalence of psychotropic drug use in our society is increasing especially in older adults, thereby provoking severe adverse drug reactions (ADR). To identify specific patient risk profiles associated with psychotropic drug use in the situation of polymedication. Methods Cases of ADRs in general emergency departments (ED) collected within the multi-center prospective observational study (ADRED) were analyzed (n=2215). We compared cases with use of psychotropic drugs and without concerning their clinical presentation at the ED. Results A third of patients (n=731, 33%) presenting to the ED with an ADR took at least 1 psychotropic drug. Patients with psychotropic drug use tended to be older, more often female, and took a higher number of drugs (all p<0.001). The frequency of falls was almost 3 times higher than compared to the non-psychotropic drug group (10.5 vs. 3.9%, p<0.001), and similar syncope was also more often seen in the psychotropic drug users (8.8 vs. 5.5%, p=0.004). The use of psychotropic drugs increased the risk for falls by a factor of 2.82 (OR, 95% CI (1.90–4.18)), when adjusting for gender, age, numbers of pre-existing diseases, and drugs, respectively. Discussion The association of psychotropic drug use with fall and syncope in combination with polymedication and older age leads to the suspicion that psychotropic drugs might be potentially harmful in specific risk populations such as older adults. It may lead us to thoroughly weigh the benefit against risk in a patient-oriented way, leading to an integrative personalized therapy approach.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 51%

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Prevalence of Psychotropic Drugs in Cases of Severe Adverse Drug Reactions Leading to Unplanned Emergency Visits in General Hospitals

et al. 2020

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“…Aktuelle Stu dien zeigen, dass auch in Deutschland fast jeder 10. Patient aufgrund einer unerwünschten Arzneimittelwirkung oder eines Medikationsfehles die Notaufnahme aufsucht [1]. Darüber hinaus werden aber in der Notaufnahme auch Medikamente appliziert und Empfehlungen für die weitere Therapie abgegeben.…”

Section: Einführungunclassified

Arzneimittelsicherheit in und durch Notaufnahmen

2018

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ZusammenfassungDer individuelle Erfolg einer Arzneimitteltherapiesicherheit (AMTS) in der Notaufnahme (NA) beruht auf der differenzierten Abstimmung von Pharmaka auf die besondere Situation des Notfallpatienten. In der folgenden Übersichtsarbeit wird an Fallbeispielen herausgearbeitet, welche Risiken bei der Indikationsstellung, Applikation und Dosierung auftreten können. Die derzeitigen Systemprobleme für eine sichere Notaufnahme-AMTS sind: keine EDV-basierte AMTS, nicht in allen Notaufnahmen aktuelle EDV-Literaturdatenbanken und keine Einweisung analog MPG (Medizinproduktegesetz)/kein Training in Notfallpharmakologie.

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“…Adverse drug reactions (ADRs) are common, can lead to emergency department (ED) visits, and hospital admissions. [1][2][3][4][5][6][7][8][9] Thereby ADRs can generate relevant health care costs. 1,2 Moreover, ADRs can be harmful and followed by complications leading to morbidity or even death.…”

Section: Introductionmentioning

confidence: 99%

The phenotype of adverse drug effects: Do emergency visits due to adverse drug reactions look different in older people? Results from the ADRED study

Just

Dormann

Schurig

et al. 2020

Brit J Clinical Pharma

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Older patients in particular suffer from adverse drug reactions (ADR) when presenting in the emergency department. We aimed to characterise the phenotype of those ADRs, to be able to recognise an ADR in older patients. Methods: Cases of ADRs in emergency departments collected within the multicentre prospective observational study (ADRED) were analysed (n = 2215). We analysed ADR-associated diagnoses, symptoms and their risk profiles. We present frequencies and odds ratios (OR) with 95% confidence intervals for adults (18-64 years) compared to older adults (≥65 years; young-old 65-79, old-old ≥80 years) and regression coefficients (B) for each year of age. Results: Most prominent differences were seen for drug-associated confusion, dehydration, and bradycardia (OR 6.70 [1.59-28.27], B .054; OR 6.02 [2.41-15.03], B .081, and 4.82 [2.21-10.54], B .040), more likely seen in older adults. Bleedings were reported in all age groups, but gastrointestinal bleedings occurred with more than doubled chance in older adults (OR 2.46 [1.77-3.41], B .030), likewise did other bleedings such as haemorrhage from respiratory passages (OR 2.89 [1.37-6.11], B.036). Falls were more likely in older adults (OR 2.84 [1.77-4.53], B .030), while dizziness was frequent in both age groups. Conclusion: Our data point to differences in symptoms of ADRs between adults and older individuals, with dangerous drug-associated phenomena in the older adult such as bleedings or falls. Physicians should consider drug-associated origins of symptoms in older adults with an increased risk for serious health problems.

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Adverse Drug Reactions (ADR) and Emergencies

Cited by 65 publications

References 30 publications

Prevalence of Psychotropic Drugs in Cases of Severe Adverse Drug Reactions Leading to Unplanned Emergency Visits in General Hospitals

Prevalence of Psychotropic Drugs in Cases of Severe Adverse Drug Reactions Leading to Unplanned Emergency Visits in General Hospitals

Arzneimittelsicherheit in und durch Notaufnahmen

The phenotype of adverse drug effects: Do emergency visits due to adverse drug reactions look different in older people? Results from the ADRED study

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