Evaluation of Predisposing Factors Associated with Suspected Adverse Drug Reactions of Hospitalized Patients

Abstract

Objectives: To study the incidence and to evaluate the risk factors of suspected adverse drug reactions developed in the hospitalized patients of various departments and to assess the causality and severity of adverse drug reactions (ADRs). Methods: It was a retrospective-prospective study conducted in a tertiary care hospital for a period of two years two months, with a specific predefined criterion. A total of 254 subjects with ADRs were identified during the period of study for which 1:1 ratio of subjects with non-ADRs were taken. Subjects of all age groups and of either sex were enrolled. Risk factors included subjects' age group, gender, polypharmacy, comorbidity, intercurrent diseases and concurrent interactive drugs. Statistical analysis used: Multiple logistic regression analysis was performed to find the association of risk factors with adverse drug reactions. Results: The incidence of suspected adverse drug reactions in hospitalized patients was13% (254/1952, 95%CI). Polypharmacy was the most significant predictor of adverse drug reactions (OR=55.952; 95%CI). Elderly population with multidrug therapy had developed the higher rate of ADRs. Cephalosporin's 27.6%, fluoroquinolones 15.5%, penicillamines 12.1%, anti-hypertensive 8.7%, NSAIDs 8.3% were more frequently implicated. Risk factors for suspected ADRs were: age (more than 60 years) (OR=1.033: 95% CI), gender [Male (OR=55.952; 95% CI)], comorbidity (OR=1.008; 95% CI), intercurrent diseases (OR=19.27; 95% CI). Conclusion: Polypharmacy, history of ADR, concurrent interactive drugs and inter current disease were the significant risk factors of adverse drug reactions. The elderly population was the vulnerable age group for ADRs. Multidrug therapy and comorbidity resulted in higher risk of ADRs in an older population. The Higher rate of suspected ADRs were probable and very less severe. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. Mudigubba et al.: Evaluation of Predisposing Factors Associated with Suspected Adverse Drug Reactions of Hospitalized PatientsJournal of Young Pharmacists, Vol 10, Issue 2, Apr-Jun, 2018203 were interviewed about the previous medical and medication history, co-morbid conditions, lifestyle and diet which were also updated inpatient case sheet for future reference. Retrospectively case data was collected from the reported documents which were stored in drug information centre and control data from the medical record database of the hospital. The patients who had no ADR were selected as controls. The severity of suspected adverse effects was assessed as mild, moderate and severe by using the specific standard scale called Hart wig and Siegel's scale, and the Naranjo`s algorithm was used to assess the causal relationship between the suspected drug and ADR. For evalu...

Causality and preventability assessment of adverse drug reactions and adverse drug events of antibiotics among hospitalized patients: A multicenter, cross-sectional study in Lahore, Pakistan

“…This is primarily because of the reason that the risk of drug interactions increases when more number of drugs are prescribed to the patients which leads to the development of ADEs [ 65 ]. Similar to findings of previously published studies [ 66 – 68 ], a significant association was found in current study between male gender and ADEs. In contrast to this, other studies depict that antibiotics associated ADEs are more commonly found among females as compared to males [ 69 , 70 ].…”

A Systematic Review of Risk Factors of Adverse Drug Reactions in Hospitalized Patients

“…Polypharmacy was the most consistent and highly acknowledged predictor witnessed in almost all the literature to quantify the risk associated with ADR [1,15,24,[26][27][28][29]34]. In continuation, few studies quoted that polypharmacy is chosen when a patient presents with multiple comorbidities in order to augment the initial therapy and advanced age of patients who may require drugs with varied mechanisms of action [35]. However, polypharmacy intensifies the possibility of ADRs due to drug-drug interactions from 2% to 5% [36][37][38][39][40] and may heighten it up to 9% with each additional prescribed drug thereafter [27].…”

“…Moreover, females are known to use oral contraceptives, hormonal supplements adding on to increased number of drugs, especially in their reproductive years, and vitamin and mineral supplements during pre and postmenopausal periods that may predispose them for ADRs [55]. However, few studies recommended that it was not a significant risk factor of ADR through their observations [35,56].…”

“…There are various factors that predispose patients to ADRs such as polypharmacy, age, intercurrent diseases, comorbidity, gender, history of ADRs, and length of hospital stays [12]. Although few authors have explored the relationship between the risk factors and ADRs [13][14][15], there exists a controversial corroboration due to differences in definitions, study settings, study designs, study population, statistical methods, race, and ethinicity [16].…”

Reacciones adversas a medicamentos en un hospital de tercer nivel en Ciudad Victoria, México

“…La interacción puede aumentar o disminuir los efectos de los fármacos implicados y puede causar toxicidad inesperada, provocando una reacción adversa. Otros factores se relacionan con la comorbilidad, ya que si además de la enfermedad que se está tratando el paciente sufre otra enfermedad (como una alteración renal, hepática o cardiaca), se pueden requerir precauciones especiales para el tratamiento de las enfermedades intercurrentes y los fármacos concurrentes interactivos, especialmente cuando existen antecedentes de RAM en el paciente 4,5 .…”