Drug-related admissions to an Australian hospital

Abstract

This study was conducted to determine the prevalence of drug-related hospital admissions in southern Tasmania, Australia. The causes of consecutive admissions to medical wards of the Royal Hobart Hospital were reviewed. Comprehensive data were collected over a 10-week period on 691 admissions (median age: 67 years and range: 11-97 years; 50.8% males). Sixty-eight (9.8%) of the admissions were classified as being either probably or definitely drug-related. Most of these admissions were attributable to intentional overdose (38.2%) or an adverse drug reaction (30.9%). The overdoses often involved benzodiazepines or antipsychotics. Gastrointestinal bleeding related to the use of nonsteroidal anti-inflammatory drugs was the most common adverse drug reaction (38.1% of all reactions). Other drug-related admission categories were poor compliance (14.7%), dosage decrease or therapy cessation by a doctor producing an exacerbation of symptoms (7.4%), substance abuse (4.4%) and drug interaction (4.4%). Patients with a drug-related admission were, on average, younger than the other medical admissions, with no significant difference in gender. Patients admitted due to an overdose or substance abuse were younger than other drug-related admissions and non-drug related admissions. In conclusion, this study has determined that almost 10% of medical admissions to the hospital are drug-related and it is estimated that 40 to 50 elderly people are admitted each year suffering from gastrointestinal bleeding related to nonsteroidal anti-inflammatory drugs.

Prospective, non-interventional, uncontrolled, open-chart, pharmacoepidemiologic study of prescribing patterns for anti-diabetic drugs at tertiary care hospital in Erode

“…However, the patterns of drug prescribing are often inappropriate. [2,3] General practice database has been used as an effective method for pharmacoepidemiologic research. [4] Until 1990s, prescribers had two classes of drug to control hyperglycaemia (insulin and sulfonylurea).…”

Mechanisms of Drug Interactions

“…It has long been established that elderly patients use more medicaments than younger age groups (LANDAHL 1987;WILLIAMS and LOWENTHAL 1992;SLOAN 1992;STEWART and COOPER 1994) and thus have a greater risk of drug-drug interactions occurring (KELLAWAY and MCCRAE 1973;LAWSON and JICK 1976;LEVY et al 1980;WILLIAMSON and CHOPIN 1980;SIMONS et al 1992;SCHENKER and BAY 1994;STANTON et al 1994;STEWART and COOPER 1994) (Fig. 1).…”

“…It was found that 40% of patients taking quinidine were also taking a digitalis glycoside, and nearly one-third of patients taking warfarin were also taking a drug with an interacting potential. STANTON et al (1994) studied drug-related admissions to an Australian hospital. The sample size of the study was 463 patients, of whom 332 attended the medical clinic and 131 attended the geriatric clinic.…”

In vitro-In vivo Drug Interaction Study of Paracetamol and Propranolol Hydrochloride

“…6,7 The elderly populations are at increased risk because of decreased functioning of the systems, more number of medications due to comorbidities, and complicated drug regimens. 8,9 When two drugs are concomitantly administered through oral route, the dissolution pattern of one drug may affect the dissolution of the other. During poly pharmacy there may be increased or decreased acidity in gastric environment and hence degree of ionization of one drug in the presence of other in stomach pH may get altered which affects the disintegration and dissolution of tablet dosage forms.…”