Adverse drug reactions as a cause for admissions to a department of internal medicine

Abstract

The prevalence of drug-related problems causing or contributing to admission to a clinic of internal medicine is high and is dominated by type A reactions, i.e. reactions in principle predictable and preventable. This implies a possibility to increase drug safety by preventive measures.

Impact of the Lund Integrated Medicines Management (LIMM) model on medication appropriateness and drug-related hospital revisits

“…In the reviewing process, we combined clinical judgment with the use of predetermined triggers, namely combinations of drugs and symptoms or certain "highalert" medications [3][4][5]23,24]. As shown in Figure 2, the initial review, which was performed by a research assistant supported by an experienced clinical pharmacist, was followed by a final review by a multi-professional expert group of senior researchers and clinicians (one clinical pharmacist, one clinical pharmacologist, one consultant in internal medicine/geriatrics and one general practitioner).…”

“…However, problems associated with drug treatment are frequent among elderly hospitalised patients [1,2] and, for some patients, it can be a drug-related problem that causes the hospital admission [3][4][5]. Many drug-related problems can be solved or prevented; it has been estimated that more than half of the drug-related admissions to hospital are preventable [6].…”

Effects of e-mails containing ADR information and a current case report on ADR reporting rate and quality of reports

“…Adverse drug reactions (ADRs) are a major health care problem and a common cause for hospital care [1][2][3]. Consequently, an analysis of risks and benefits is essential before initializing drug treatment in patients.…”

“…It is an important method for detecting signals, which is one aim of pharmacovigilance. In Sweden, authorized prescribing health care providers (physicians, dentists) and nurses are obliged to report (1) serious ADRs, (2) ADRs not mentioned in the summary of product characteristics (SPC), (3) ADRs related to the use of new drugs (≤2 years on the market) except those labeled as common in the SPC and (4) ADRs whose incidence seems to increase [4], the latter obviously being difficult for any individual to identify. All ADR reports are reviewed by trained nurses (MLJ, GB) and clinical pharmacologists (SMW) at regional pharmacovigilance centers, after which they are entered in the SWEdish Drug Information System (SWEDIS).…”

Nurse-led medication reviews and the quality of drug treatment of elderly hospitalized patients

“…Other Swedish population-based studies among people 75 years and older have shown that inappropriate drug use (IDU) is common, with a prevalence of 16.5-19% [8,12]. IDU is associated with adverse drug events (ADEs) and is an important reason for unplanned admittance to hospital of elderly people [8,[16][17][18][19]. The proportion of drug-related hospital admissions has been shown to be up to 6%, with a substantially higher proportion among elderly patients [2,17,18,[20][21][22].…”