Drug‐Related Visits to a District Hospital Emergency Room

Juntti‐Patinen, Laura; Kuitunen, Tapio; Péré, P.; Neuvonen, Pertti J.

doi:10.1111/j.1742-7843.2006.pto_264.x

Cited by 33 publications

(35 citation statements)

References 28 publications

(67 reference statements)

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“…Therefore, comparison of the results between studies is difficult. However, antibiotics are usually mentioned as one major drug group causing fatal ADRs [6,10,24,27,28]. In the present study, only two fatal ADRs were due to antibiotics.…”

Section: Discussionmentioning

confidence: 39%

Drug‐Related Inadvertent Deaths in a University Hospital – A Declining Trend

Lapatto‐Reiniluoto

Patinen

Niemi

et al. 2015

Basic Clin Pharma Tox

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Abstract:We studied the incidence of fatal adverse drug reactions (ADRs) in a tertiary hospital to find out which drugs were involved. The secondary objective was to compare the data from the same hospital published 12 years earlier. All 1708 death cases in the Helsinki University Central Hospital during the year 2012 were retrospectively evaluated. All suspected drug-related deaths, excluding suicides, were scrutinized by an expert panel using the WHO ADR probability classification. Of all cases, 52 (3.0%) were classified as certainly or probably drug related and 24 (1.4%) as possibly drug related. Together, these corresponded to 0.02% of all hospital admissions. The most commonly involved drugs in certain or probable cases were cytostatics (18 cases, 1.1% of all cases) and antithrombotics (17, 1.0%). Twelve years earlier, these caused 27 (1.8%) and 22 (1.5%) cases, respectively. Non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids caused less (2 and 0 cases) fatal ADRs than earlier (12 and 4 cases, p = 0.048 and p = 0.005, respectively). Most of the ADRs leading to death were present already in admission and affected seriously ill or elderly patients. Hospital-born fatal ADRs occurred in 0.003% of patients. In conclusion, cytostatics and antithrombotics are still the leading causes of fatal ADRs, but NSAIDs and glucocorticoids seem to cause fatal ADRs less often than previously. The incidence of fatal ADRs in 2012 was 3.0% of all deaths, suggesting a decline compared to the 2000 value (5.0%). Improved awareness, prevention and treatment of ADRs and safer medicines may explain these declining trends.

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Section: Discussionmentioning

confidence: 39%

Drug‐Related Inadvertent Deaths in a University Hospital – A Declining Trend

Lapatto‐Reiniluoto

Patinen

Niemi

et al. 2015

Basic Clin Pharma Tox

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“…The period under study varied widely and ranged from 1 week to 11 years. The majority of studies where described as being performed in a hospital outpatient or accident emergency department (n = 21) [25], [25], [47], [55], [78], [80]–[84], [86]–[97]. Nine studies were performed in general practice [98]–[106].…”

Section: Resultsmentioning

confidence: 99%

Adverse Drug Reactions in Children—A Systematic Review

et al. 2012

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BackgroundAdverse drug reactions in children are an important public health problem. We have undertaken a systematic review of observational studies in children in three settings: causing admission to hospital, occurring during hospital stay and occurring in the community. We were particularly interested in understanding how ADRs might be better detected, assessed and avoided.Methods and FindingsWe searched nineteen electronic databases using a comprehensive search strategy. In total, 102 studies were included. The primary outcome was any clinical event described as an adverse drug reaction to one or more drugs. Additional information relating to the ADR was collected: associated drug classification; clinical presentation; associated risk factors; methods used for assessing causality, severity, and avoidability. Seventy one percent (72/102) of studies assessed causality, and thirty four percent (34/102) performed a severity assessment. Only nineteen studies (19%) assessed avoidability. Incidence rates for ADRs causing hospital admission ranged from 0.4% to 10.3% of all children (pooled estimate of 2.9% (2.6%, 3.1%)) and from 0.6% to 16.8% of all children exposed to a drug during hospital stay. Anti-infectives and anti-epileptics were the most frequently reported therapeutic class associated with ADRs in children admitted to hospital (17 studies; 12 studies respectively) and children in hospital (24 studies; 14 studies respectively), while anti-infectives and non-steroidal anti-inflammatory drugs (NSAIDs) were frequently reported as associated with ADRs in outpatient children (13 studies; 6 studies respectively). Fourteen studies reported rates ranging from 7%–98% of ADRs being either definitely/possibly avoidable.ConclusionsThere is extensive literature which investigates ADRs in children. Although these studies provide estimates of incidence in different settings and some indication of the therapeutic classes most frequently associated with ADRs, further work is needed to address how such ADRs may be prevented.

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“…In these reports, the study team was often multidisciplinary, and may have included physicians, pharmacists, or nurses. Seven additional studies also described initial clinician determination of DRVs, but did not report additional independent case adjudication [18], [19], [26], [27], [36], [37], [40]. Ten studies did not provide information about who identified the DRVs [20], [22], [23], [28], [31], [35], [38], [39], [46], [47].…”

Section: Resultsmentioning

confidence: 99%

Drug-Related Hospital Visits and Admissions Associated with Laboratory or Physiologic Abnormalities—A Systematic-Review

2013

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Countless studies have demonstrated that many emergency-room visits and hospital admissions are drug-related and that a significant proportion of these drug-related visits (DRVs) are preventable. It has not been previously studied which DRVs could be prevented through enhanced monitoring of therapy. The objective of the study was to determine the incidence of DRVs attributed to laboratory or physiologic abnormalities. Three authors independently performed comprehensive searches in relevant health care databases using pre-determined search terms. Articles discussing DRV associated with poisoning, substance abuse, or studied among existing in-patient populations were excluded. Study country, year, sample, design, duration, DRV identification method, proportion of DRVs associated with laboratory or physiologic abnormalities and associated medications were extracted. The three authors independently assessed selected relevant articles according to the Strengthening the reporting of observational studies in epidemiology (STROBE) as applicable according to the studies' methodology. The initial literature search yielded a total of 1,524 articles of which 30 articles meeting inclusion criteria and reporting sufficient laboratory or physiologic data were included in the overall analysis. Half employed prospective methodologies, which included both chart review and patient interview; however, the overwhelming majority of identified studies assessed only adverse drug reactions (ADRs) as a drug-related cause for DRV. The mean (range) prevalence of DRVs found in all studies was 15.4% (0.44%–66.7%) of which an association with laboratory or physiologic abnormalities could be attributed to a mean (range) of 29.4% (4.3%–78.1%) of cases. Most laboratory-associated DRVs could be linked to immunosuppressant, antineoplastic, anticoagulant and diabetes therapy, while physiologic-associated DRVs were attributed to cardiovascular therapies and NSAIDs. Significant proportions of laboratory and physiologic abnormalities contribute to DRVs and are consistently linked to specific drugs. These therapies are potential targets for enhanced medication monitoring initiatives to proactively avert potential DRVs.

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Drug‐Related Visits to a District Hospital Emergency Room

Cited by 33 publications

References 28 publications

Drug‐Related Inadvertent Deaths in a University Hospital – A Declining Trend

Drug‐Related Inadvertent Deaths in a University Hospital – A Declining Trend

Adverse Drug Reactions in Children—A Systematic Review

Drug-Related Hospital Visits and Admissions Associated with Laboratory or Physiologic Abnormalities—A Systematic-Review

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