Frequency, Characteristics, and Predictive Factors of Adverse Drug Events in an Adult Emergency Department according to Age: A Cross-Sectional Study

Abstract

Adverse drug events (ADEs) are a major public health concern, given their consequences in terms of morbi-mortality and associated healthcare costs. Many studies have focused on the elderly, who are considered particularly vulnerable in this respect. We aimed to determine and compare the frequency, characteristics, and predictive factors of ADEs according to age in an adult population. A prospective seven-year cross-sectional study was conducted in a university hospital emergency department. Structured medication reviews and ADE detection were performed. Patient data and ADE characteristics were collected. Descriptive statistics and logistic regression were performed in two age groups: Group 1 (age <65 years) and 2 (age ≥65 years). Among the 13,653 patients included, 18.4% in Group 1 and 22.6% in Group 2 experienced an ADE. Differences were identified in terms of the ADE type (more ADEs due to noncompliance in Group 1) and ADE symptoms (greater bleeding in Group 2). In the multivariable analysis, several specific predictive factors were identified, including kidney failure and antidiabetic drug use in Group 1 and inappropriate prescription and antithrombotic treatment in Group 2. Analysis by age provided a more refined vision of ADEs as we identified distinct profiles of iatrogenesis. These results will lead to a better detection of ADEs.

Life‐threatening bronchospasm induced by an angiotensin‐converting enzyme inhibitor in a chronically ventilated patient: Diagnostic pitfalls and literature review

“…Globally, the costs associated with medication errors have been estimated at USD 42 billion annually 18 . Adverse drug reactions have been reported in about 20% of patients in emergency rooms 19 . In a systematic review of studies addressing adverse drug reactions‐induced hospital admissions in patients over 60 years of age, the overall average percentage of hospital admissions related to adverse drug reactions was 8.7% among all admissions 20 .…”

“…18 Adverse drug reactions have been reported in about 20% of patients in emergency rooms. 19 In a systematic review of studies addressing adverse drug reactions‐induced hospital admissions in patients over 60 years of age, the overall average percentage of hospital admissions related to adverse drug reactions was 8.7% among all admissions. 20 Iatrogenic illness is a major cause of additional in‐hospital life‐threatening complications and death.…”

Involvement of Pharmacists in the Emergency Department to Correct Errors in the Medication History and the Impact on Adverse Drug Event Detection

“…This study is ancillary to a study on ADE detection in EDs (ADEsED). This prospective observational monocentric study was conducted in the adult ED of a university hospital in France, from November 2011 to November 2018, and the primary objective was to assess the rate and characteristics of ADEs identified by the pharmacist team in an ED [34][35][36]. Participation in the study was proposed by clinical pharmacists for all adult patients (>18 years) admitted to the ED during the study period.…”