Trends in hospital admissions due to antidepressant-related adverse drug events from 2001 to 2011 in the U.S.

Abstract

BackgroundDepression is a prevalent mental health disorder and the fourth leading cause of disability in the world as per the World Health Organization. Use of antidepressants can lead to adverse drug events (ADEs), defined as any injury resulting from medication use. This study aimed to examine changes in hospital admissions due to antidepressant-related ADEs (ArADEs) among different socio-demographic groups and changes in lengths of stay (LOS) and hospital charges in ArADE admissions from 2001 to 2011.MethodsThe Healthcare Cost and Utilization Project database was used. ArADE admissions in different socio-demographic groups were examined including characteristics such as age, gender, rural/urban, and income. LOS and hospital charges for ArADE cases were compared between 2001 and 2011. Chi-square test and t test were used for statistical analyses.ResultsThere were 17,375 and 20,588 ArADE related admissions in 2001 and 2011, respectively. There was a 17.6% increase among the group of 18 to 64 years old and a 64.8% increase among the group of 65 years or older while the other age groups experienced decreased admission rates. Males and females had similar increases. Patients from the lower income areas experienced a two-fold increase while those from the higher income areas experienced a decrease. The mean LOS for all ArADE related admissions increased from 2.18 to 2.81 days and mean hospital charges increased from $8,456.2 to $21,572.5.ConclusionsThere was an increase in ArADE hospital admissions. The greater increase in ArADE admissions among elderly, urban or low-income patients should be noted and addressed by practitioners and policy makers. The large increase in hospital charges needs further research.

Trends in Antidepressant Use and Expenditure in Six Major Cities in China From 2013 to 2018

“…The choice of an antidepressant is influenced by drug profiles, physician characteristics, patient characteristics, regulation and reimbursement policies, and other factors (9). Antidepressants can induce several severe adverse effects, including self-inflicted injury, myocardial infarction, and stroke (10)(11)(12). Discontinuing or decreasing use of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), may lead to the appearance of withdrawal symptoms (13)(14)(15).…”

Custos hospitalares associados aos eventos adversos medicamentosos: Revisão sistemática

“…(Figura 1). Figura 1 -Diagrama de fluxo e seleção dos estudos incluídos: Elaboração: Autores (2020), Após a leitura na íntegra, oito estudos preencheram os critérios de inclusão e foram inseridos na presente revisão sistemática (Evans et al, 1993;Cullen, et al, 1997;Lagnaoui et al, 2000;Pirmohamed et al, 2004;Hug et al, 2012;Du et al, 2013;Nazer et al, 2013;Parihar et al, 2017). Cinco estudos foram excluídos, sendo dois excluídos por reportarem apenas as EAM sem os custos associados (Rozenfeld, Giordani & Coelho, 2013;Gutiérrez-Mendoza et al, 2015), dois estudos reportaram os custos associados aos EA de modo geral (Porto et al, 2010;Camargo et al, 2011) e um artigo era revisão integrativa (Vilela et al, 2018).…”

“…Os oitos estudos observacionais incluídos na análise foram publicados de 1993 a 2017 sendo a maioria americano (cinco estudos) (Evans et al, 1993;Cullen, et al, 1997, Hug et al, 2012Du et al, 2013, Parihar et al, 2017 um Francês (Lagnaoui et al, 2000), um do Reino Unido (Pirmohamed et al, 2004) e um do oriente médio (Nazer et al, 2013).…”

“…A avaliação do risco de viés dos estudos incluídos no presente estudo demonstrou que no domínio igualdade entre as coortes expostas e não expostas serem retiradas da mesma população há quatro estudos com baixo risco (Evans et al, 1993, Lagnaoui et al, 2000, Du et al, 2013, Nazer et al, 2013) e quatro estudos com alto risco de viés, pois um estudo comparou EAM em pacientes de UTI versus não UTI (Cullen, et al, 1997), um estudo comparou pacientes cm EAM em todas as unidades de sua dependência (Pirmohamed et al, 2004), outro estudo era multicêntrico (Hug et al, 2012) e o outro comparou EAM a antidepressivos em todas as idades e populações (Parihar et al, 2017).…”

Clinical Outcomes of Failing to Dose-Reduce Cephalosporin Antibiotics in Older Adults with CKD

“…We used multivariable logistic regression analyses to address confounding variables and estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the risk of our outcomes with a higher dose of cephalosporin, with the dose-reduced group as the reference. We a priori decided to adjust for six potential confounders that are known risk factors for adverse drug reactions: age, sex, income quintile, living in a long-term care residence, the duration of dispensed cephalosporin, and baseline evidence of dementia (25)(26)(27)(28)(29). After reviewing the baseline table for characteristics with meaningful differences between groups (standardized difference $10%), we added eight other potential confounders to our models: the type of cephalosporin antibiotic, receipt of a wound swab, receipt of a urinalysis, receipt of an influenza vaccination, evidence of urinary tract infection, baseline eGFR, the number of serum creatinine measurements in the prior year, and number of primary care physician visits in the prior year.…”