Aim: to establish the percentage hospital admission related to adverse drug reactions (ADRs) from the data available in the literature. Method: literature search in the Medline database, metaanalysis. Results: from the literature it is revealed that a considerable part of all hospital admissions are related to adverse drug reactions. However, these data are not homogenous, i.e. larger studies display a lower percentage of ADR related hospital admission, while smaller studies display a higher percentage. Subgroup analysis showed that for elderly people the odds of being hospitalised by ADR related problems is 4 times higher than for younger ones (16.6% vs. 4.1%). A considerable part of these hospitalisations can be prevented. Subgroup analysis revealed that in the elderly up to 88% of the ADR related hospitalisations are preventable; for the non-elderly this is only 24%. Comparatively more elderly people are hospitalised than younger ones. Combining these findings, twice as much elderly people are hospitalised by ADR related problems than non-elderly, while preventability of ADR related hospitalisation might yield 7 times more people in the elderly than in the non-elderly. The estimation of the costs of ADR related hospitalisations in the Health Care system in The Netherlands is discussed. Conclusion: many elderly people are hospitalised by ADR related problems; an important part of these hospitalisations can be avoided.

Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies.

Objective:To determine the prevalence of hospital admissions associated with ADRs and examine differences in prevalence rates between population groups and methods of ADR detection.Data Sources:Studies were identified through electronic searches of Cumulative Index to Nursing and Allied Hearth Literature. EMBASE, and MEDLINE to August 2007. There were no language restrictions.Study Selection and Data Extraction:A systematic review was conducted of prospective observational studies that used the World Health Organization ADR definition. Subgroup analysis examined the influence of patient age groups and methods of ADR detection on reported ADR admission rates. All statistical analyses were performed using STATA v 9.0.Data Synthesis:Twenty-five studies were identified including 106, 586 patients who were hospitalized; 2143 of these patients had experienced ADRs. The prevalence rates of ADRs ranged from 0.16% to 15.7%, with an overall median of 5.3% (interquartile range [IQR] 2.7–9.0%). Median ADR prevalence ...

Hospital Admissions Associated with Adverse Drug Reactions: A Systematic Review of Prospective Observational Studies

BACKGROUND:Adverse drug reactions (ADRs) are a significant cause of hospital admissions. These events can lead to significant morbidity and mortality and financial costs. ADRs that may be preventable might be considered a form of medication error.OBJECTIVE:To assess the potential preventability of ADRs directly related to a patient's hospital admission.METHODS:A retrospective chart review of 437 ADRs occurring during an 11-month period was conducted at a university hospital. A subset of these events leading to hospital admissions was identified for further review. Those that resulted in admission were further examined to determine probability of causality, severity, and preventability.RESULTS:Over 11 months, 158 ADRs were directly related to hospital admission. The relationship of these admissions to drug exposure was determined to be probable or highly probable in 154 (97.4%) of these cases. From this group, 96 (62.3%) of these events were considered potentially preventable, with 23 (24%) considered seve...

Hospital Admissions Resulting from Preventable Adverse Drug Reactions

Background: We examined the effect of a home-based intervention (HBI) on readmission and death among “high-risk” patients with congestive heart failure discharged home from acute hospital care.

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Effects of a home-based intervention among patients with congestive heart failure discharged from acute hospital care

Objective:To estimate the incidence and describe characteristics of preventable adverse drug events (pADEs) in ambulatory care.Data Sources:Studies were searched in PubMed (1966–March 2007), International Pharmaceutical Abstracts (1970–December 2006), the Cochrane database of systematic reviews (1993–March 2007), EMBASE (1980–February 2007), and Web of Science (1945–March 2007). Key words included medication error, adverse drug reaction, iatrogenic disease, outpatient, ambulatory care, primary health care, general practice, patient admission, hospitalization, observational study, retrospective studies, health services research, and follow-up studies. Additional articles were found in the reference sections of retrieved articles.Study Selection and Data Extraction:Peer-reviewed articles assessing pADEs in ambulatory care, with detailed descriptions/frequency distributions of (1) ADE/pADE incidence, (2) clinical outcomes, (3) associated drug groups, and/or (4) underlying medication errors were included. Stu...

Systematic Review of the Incidence and Characteristics of Preventable Adverse Drug Events in Ambulatory Care

Background: Ultrasound assessment of the axilla remains an important diagnostic component in the pre-operative investigation of breast cancer, which helps determine the surgical management of the axilla. The threshold to biopsy an axillary node based on its cortical thickness can vary between centres, with no current nationally agreed consensus within the UK. Our centre recently changed its threshold for axillary node biopsy from a cortical thickness of 2.5 mm to 3 mm, based on recent evidence. We retrospectively analysed our own data to assess the potential impact of this change on patient management. 

Sonographic assessment of the axilla in breast cancer: changing the threshold

Objectives: To determine the incidence of hospital admissions for adverse events related to drug therapy, and to assess whether these drug-related admissions (DRAs) could have been reasonably prevented. Setting: A tertiary teaching hospital. Design and patients: Prospective assessment of all admissions through the emergency department and resulting in a stay of more than 24 hours during 30 consecutive days in November and December 1994 to determine if the admission was related to drug therapy. Cases of intentional overdose were excluded. Main outcome measures: The number, type, causality and avoidability of drug-related admissions. Results: Of 965 admissions, 55 (5.7%) were assessed as being drug-related. Drug-related admissions (DRAs) were designated possibly (38%), probably (46%) or definitely (16%) drug-related; caused by prescribing factors (26%), patient noncompliance (27%) and adverse drug reactions (47%); and classified as definitely (5.5%), possibly (60.0%) and not (34.5%) avoidable. The estimated annual cost to the hospital for all DRAs was $3,496,956 and for unavoidable DRAs was $1,629,494. Conclusion: The DRA rate we found lies around the middle of the range of other published rates. Few DRAs were judged definitely avoidable end over one-third were unavoidable. Nevertheless, the largest proportion were judged possibly avoidable. As the drugs identified in this study are clearly needed in the community, efforts to reduce DRAs must concentrate on education, counselling and monitoring of drug therapy.

Hospitalisation for adverse events related to drug therapy: incidence, avoidability and costs

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Sonographic assessment of the axilla in breast cancer: changing the threshold

Hospitalisation for adverse events related to drug therapy: incidence, avoidability and costs