Adverse drug reactions which provoke hospital admission

Abstract

Objective: To identify, classify and quantify the frequency of negative clinical adverse drug reactions (ADR) resulting in hospital admission from the emergency department (ED). To determine ADR preventability, identify ADR-related admission factors, calculate related costs and recognise which drugs are the most often involved.

Method: Cross-sectional, prospective and observational study of patients that were admitted to hospital from the ED. We used the Dader method to detect ADR. We classified ADR in accordance with the Tercer Consenso de Granada (third Granada consensus), and calculated ADR preventability using the Schumock and Thornton scales (modified by Otero et al), and ADR severity according to Schneider. We considered the direct costs generated during the hospital stay for the economic study. We analysed the correlation between ADR and age, sex, kidney and liver failure, and drug use. We used multiple logistic regression analysis to identify risk factors.

Results: 19.4% of admissions were the direct consequence of ADR, 65% of which were preventable. Antineoplastic therapy and immunosuppressants caused 38% of ADR. 20.4% of admissions had to be transferred to the intensive care unit (ICU) or caused permanent damage. We found statistical significance between ADR and patients undergoing hormonal therapy, 'high risk' drugs and those admitted to the endocrinology department. The ADR-associated cost was €237,377.

Conclusions: ADR-related admission is a problem with a high prevalence, and most cases are preventable.