Predictors of hospital-acquired adverse drug reactions: a cohort of Ugandan older adults

Yadesa, Tadele Mekuriya; Kitutu, Freddy Eric; Tamukong, Robert; Alele, Paul E.

doi:10.1186/s12877-022-03003-9

Cited by 5 publications

(10 citation statements)

References 45 publications

(81 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of 78 studies, 27 studies [ 18 – 44 ] were carried out among general patients, while the remaining studies [ 45 – 95 ] were carried out among specific patients. Seventeen studies [ 18 – 22 , 24 , 26 , 31 , 33 – 35 , 38 , 39 , 41 – 43 , 51 ] reported the prevalence of ADEs leading to hospital admissions, while 30 studies [ 18 , 19 , 22 – 33 , 35 , 37 – 41 , 43 , 44 , 65 , 80 , 85 – 88 , 91 , 95 ] reported the prevalence of ADEs during hospitalization. Twelve studies [ 18 , 19 , 22 , 24 , 26 , 31 , 33 , 35 , 38 , 39 , 41 , 43 ] reported ADE occurrence in both settings.…”

Section: Resultsmentioning

confidence: 99%

Variation of adverse drug events in different settings in Africa: a systematic review

Nyame,

Hu,

Xue

et al. 2024

Eur J Med Res

View full text Add to dashboard Cite

Background Adverse drug events (ADEs) represent challenges affecting Africa’s healthcare systems owing to the increased healthcare expenditure and negative health outcomes of ADEs. Objectives We aimed to systematically review published studies on ADEs and synthesize the existing evidence of ADE prevalence in Africa. Methods Studies reporting on ADE occurrence in African settings and published from Jan 1, 2000 to Oct 1, 2023 were identified by searching PubMed, EBSCO, Science Direct, and Web of Science. Studies that either articulately investigated ADEs caused by clinical condition (such as HIV patients) or ADEs caused by exposure to specific drug(s) (such as antibiotics) were considered specific and the remaining were general. Grouped ADE prevalence rates were described using median and interquartile range (IQR). PROSPERO registration (CRD42022374095). Results We included 78 observational studies from 15 African countries that investigated the prevalence of ADEs leading to hospital admissions (17 studies), developed during hospitalizations (30 studies), and captured in the outpatient departments (38 studies) or communities (4 studies). Twelve studies included multiple settings. The median prevalence of ADE during hospitalization was 7.8% (IQR: 4.2–21.4%) and 74.2% (IQR: 54.1–90.7%) in general and specific patients, respectively. The ADE-related fatality rate was 0.1% and 1.3% in general and specific patients. The overall median prevalence of ADEs leading to hospital admissions was 6.0% (IQR: 1.5–9.0%); in general, patients and the median prevalence of ADEs in the outpatient and community settings were 22.9% (IQR: 14.6–56.1%) and 32.6% (IQR: 26.0–41.3%), respectively, with a median of 43.5% (IQR: 16.3–59.0%) and 12.4% (IQR: 7.1–28.1%) of ADEs being preventable in general and specific patients, respectively. Conclusions The prevalence of ADEs was significant in both hospital and community settings in Africa. A high ADE prevalence was observed in specific patients, emphasizing important areas for improvement, particularly in at-risk patient groups (e.g., pediatrics, HIV, and TB patients) in various settings. Due to limited studies conducted in the community setting, future research in this setting is encouraged.

show abstract

Section: Resultsmentioning

confidence: 99%

Variation of adverse drug events in different settings in Africa: a systematic review

Nyame,

Hu,

Xue

et al. 2024

Eur J Med Res

View full text Add to dashboard Cite

show abstract

“…For example, the risk of gastrointestinal side effects in nonsteroidal anti-inflammatory drugs (NSAIDs) could be increased if previous NSAID intolerance was identified 29 . In hospitalised older patients, a history of experiencing harmful outcomes from medications in the preceding year was shown to predict adverse drug effects from current medications 30 . A study on treatment-resistant depression also found that a history of electroconvulsive therapy and unsuccessful antidepressant trials were associated with the outcome of vagus nerve stimulation 31 .…”

Section: Discussionmentioning

confidence: 99%

Prediction of antidepressant side effects in the Genetic Link to Anxiety and Depression Study

Li,

Lin,

Davies

et al. 2024

Preprint

View full text Add to dashboard Cite

Antidepressants are the most common treatment for moderate or severe depression. Side effects are crucial indicators for antidepressants, but their expression varies widely among individuals. In this study, we leveraged genetic and medical data from self-reported questionnaires in the Genetic Links to Anxiety and Depression (GLAD) study to build prediction models of side effects and subsequent discontinuation across three antidepressant classes (SSRI, SNRI, tricyclic antidepressant (TCA)) at the first and the last (most recent) year of prescription. We included 259 predictors spanning genetic, clinical, illness, demographic, and antidepressant information. Six prediction models were trained, and their performance was compared. The final dataset comprised 4354 individuals taking SSRI in the first prescription and 3414 taking SSRI, SNRI or TCA in the last year of prescription. In the first year, the best area under the receiver operating characteristic curve (AUROC) for predicting SSRI discontinuation and side effects were 0.65 and 0.60. In the last year of SSRI prescription, the highest AUROC reached 0.73 for discontinuation and 0.87 for side effects. Models for predicting discontinuation and side effects of SNRI and TCA showed comparable performance. The history of side effects and discontinuation of antidepressant use were the most influential predictors of the outcomes in the last year of prescription. When examining 30 common antidepressant side effect symptoms, most of them were differentially prevalent between antidepressant classes. Our findings suggested the feasibility of predicting antidepressant side effects using a self-reported questionnaire, particularly for the last prescription. These results could contribute valuable insights for the development of clinical decisions aimed at optimising treatment selection with enhanced tolerability.

show abstract

“…Other studies among admitted elderly patients have reported cardiovascular drugs, nervous system agents and anti-infective agents as the cause of ADRs. 11 , 12 A study in Uganda by Kiguba et al 17 reported herbal medicines to be linked to hospital-acquired ADRs. The Uganda treatment guidelines require that misoprostol is administered from a hospital setting; however, it is a common practice for patients to self-medicate with misoprostol to initiate abortion before seeking professional care which causes adverse events such as incomplete abortion, failed abortion, missed abortion, severe anaemia, haemorrhagic shock, sepsis, ectopic pregnancy and ruptured uterus 26 requiring hospital admissions.…”

Section: Discussionmentioning

confidence: 99%

“… 6 , 10 Recent studies in Uganda among the admitted elderly implicate cardiovascular drugs, nervous system agents and anti-infective agents as the common cause of ADRs. 11 , 12 Self-medication has been highlighted to be associated with ADR-related hospitalization in HIC 13 , 14 ; however, such data are scarce in Sub-Saharan Africa (SSA) where self-medication is rampant.…”

Section: Introductionmentioning

confidence: 99%

“… 17 These studies document the epidemiology of hospital-acquired ADRs and ADRs in the elderly who do not represent the general population. 11 , 12 , 15 – 17 Thus, the burden and associated factors of ADRs linked to hospital admission are not well investigated among inpatients in SSA, particularly in Uganda, where the risk of ADR-related hospitalizations could be heightened by the colliding epidemics of infectious and non-infectious diseases. 18 This study sought to determine the burden, characteristics, contributing factors and patient outcomes of ADRs documented as the primary diagnosis linked to hospital admission among adult inpatients at a tertiary care hospital in Uganda.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hospital admissions attributed to adverse drug reactions in tertiary care in Uganda: burden and contributing factors

Asio,

Nasasira,

Kiguba

2023

Therapeutic Advances in Drug Safety

View full text Add to dashboard Cite

Background: Adverse drug reactions (ADRs) contribute to the burden of disease globally and of particular concern are ADR-related hospital admissions. Objectives: This study sought to determine the burden, characteristics, contributing factors and patient outcomes of ADRs that were the primary diagnosis linked to hospital admission among inpatients in Uganda. Design: We conducted a cross-sectional secondary analysis of data from a prospective cohort study of adult inpatients aged 18 years and older at Uganda’s Mulago National Referral Hospital from November 2013 to April 2014. Methods: We reviewed clinical charts to identify inpatients with an ADR as one of the admitting diagnoses and, if so, whether or not the hospital admission was primarily attributed to the ADR. Logistic regression was used to determine factors associated with hospital admissions primarily attributed to ADRs. Results: Among 762 inpatients, 14% had ADRs at hospital admission and 7% were primarily hospitalized due to ADRs. A total of 235 ADRs occurred among all inpatients and 57% of the ADRs were the primary diagnosis linked to hospital admission. The majority of ADRs occurred in people living with HIV and were attributed to antiretroviral drugs. HIV infection [aOR (adjusted odds ratio) = 2.97, 95% confidence interval (CI): 1.30–6.77], use of antiretroviral therapy (aOR = 5.46, 95% CI: 2.56–11.68), self-medication (aOR = 2.27, 95% CI: 1.14–4.55) and higher number of drugs used (aOR = 1.13, 95% CI: 1.01–1.26) were independently associated with hospital admissions attributed to ADRs. Conclusion: Antiretroviral drugs were often implicated in ADR-related hospital admissions. HIV infection (whether managed by antiretroviral therapy or not), self-medication and high pill burden were associated with hospital admissions attributable to ADRs. The high HIV burden in Sub-Saharan Africa increases the risk of ADR-related hospitalization implying the need for emphasis on early detection, monitoring and appropriate management of ADRs associated with hospital admission in people living with HIV.

show abstract

Predictors of hospital-acquired adverse drug reactions: a cohort of Ugandan older adults

Cited by 5 publications

References 45 publications

Variation of adverse drug events in different settings in Africa: a systematic review

Variation of adverse drug events in different settings in Africa: a systematic review

Prediction of antidepressant side effects in the Genetic Link to Anxiety and Depression Study

Hospital admissions attributed to adverse drug reactions in tertiary care in Uganda: burden and contributing factors

Contact Info

Product

Resources

About