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Habib MK, Khan MN, Sadiq A, Iqbal Q, Raziq A, Ahmad N, Iqbal Z, Haider S, Anwar M, Khilji FUR, Saleem F, Khan AH. Medication Errors and Type 2 Diabetes Management: A Qualitative Exploration of Physicians' Perceptions, Experiences and Expectations From Quetta City, Pakistan. Front Med (Lausanne) 2022; 9:846530. [PMID: 35419370 PMCID: PMC8995793 DOI: 10.3389/fmed.2022.846530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background Type 2 Diabetes-related medication errors are frequently reported from the hospitals and consequently are of major concern. However, such reports are insufficient when developing healthcare settings are pursued in literature. Keeping this inadequacy in mind, we therefore aimed to explore physicians' perceptions, experiences and expectations of medication errors when managing patients with Type 2 Diabetes Mellitus. Methods A qualitative design was adopted. By using a semi-structured interview guide through the phenomenology-based approach, in-depth, face-to-face interviews were conducted. Physicians practicing at the medicine ward of Sandeman Provincial Hospital, Quetta, were purposively approached for the study. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Results Although the saturation was reached at the 13th interview, we conducted additional two interviews to ensure the saturation. Fifteen physicians were interviewed, and thematic content analysis revealed six themes and nine subthemes. Mixed conceptualization and characterization of medication errors were identified. Medication errors were encountered by all physicians however poor understanding of the system, deficiency of logistics and materials were rated as barriers in reporting medication errors. Among contributors of medication errors, physicians themselves as well as dispensing and patient-related factors were identified. Physicians suggested targeted training sessions on medication error-related guidelines and reporting system. Parallel, establishment of an independent unit, involving the pharmacists, and strict supervision of paramedics to minimize medication errors was also acknowledged during data analysis. Conclusion With a longer life expectancy and a trend of growing population, the incidences of medication errors are also expected to increase. Our study highlighted prescribing, dispensing and administration phases as contributing factors of medication errors. Although, physicians had poor understanding of medication errors and reporting system, they believed getting insights on guidelines and reporting system is essential. A review of admission and discharge reconciliation must be prioritized and a culture of teamwork, communication and learning from mistakes is needed.
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Affiliation(s)
| | - Muhammad Naeem Khan
- Post Graduate Medical Institute, Bolan Medical Complex Hospital, Quetta, Pakistan
| | - Abdul Sadiq
- Department of Biochemistry, Jhalawan Medical College Khuzdar, Khuzdar, Pakistan
| | - Qaiser Iqbal
- Faculty of Pharmacy & Health Sciences, University of Baluchistan, Quetta, Pakistan
| | - Abdul Raziq
- Department of Statistics, University of Baluchistan, Quetta, Pakistan
| | - Nafees Ahmad
- Faculty of Pharmacy & Health Sciences, University of Baluchistan, Quetta, Pakistan
| | - Zaffar Iqbal
- Health Department, Government of Balochistan, Quetta, Pakistan
| | - Sajjad Haider
- Faculty of Pharmacy & Health Sciences, University of Baluchistan, Quetta, Pakistan
| | - Muhammad Anwar
- Faculty of Pharmacy & Health Sciences, University of Baluchistan, Quetta, Pakistan
| | | | - Fahad Saleem
- Faculty of Pharmacy & Health Sciences, University of Baluchistan, Quetta, Pakistan
| | - Amer Hayat Khan
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Malaysia
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Demessie MB, Berha AB. Prevalence and predictors of drug-related hospitalisation among patients visiting emergency departments of Addis Ababa city hospitals in Ethiopia: a multicentre prospective observational study. BMJ Open 2022; 12:e054778. [PMID: 35264351 PMCID: PMC8915323 DOI: 10.1136/bmjopen-2021-054778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/28/2022] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES This study aimed to determine the prevalence, categories and predictors of drug-related hospitalisation (DRH) among patients visiting emergency departments of Addis Ababa city hospitals, Ethiopia. DESIGN A multicentre prospective observational study was conducted through patients' interview and chart review. SETTINGS The study was undertaken in three tertiary care hospitals in Addis Ababa, Ethiopia. PARTICIPANTS A total of 423 patients fulfilling the inclusion criteria were included. OUTCOME MEASURES Prevalence and preventability of DRH, categories of drug-related problems causing DRH, medications and diseases involved in DRH, and factors significantly associated with DRH. RESULT More than half of the patients (216, 51.1%) were female. The mean age (SD) was 47.50 (±17.21) years. The mean length of hospital stay (SD) was 10.29 (±8.99) days. Nearly 60% (249) of them were hospitalised due to drug-related problems, of which 87.8% were preventable. The cause for hospitalisation for more than half (130, 53%) of them was a failure to receive drugs, and 37.85 (94) patients were categorised as untreated indications. Age ≥65 years (adjusted OR (AOR)=7.451, 95% CI: 1.889 to 29.397), tertiary educational level (AOR=0.360, 95% CI: 0.141 to 0.923), participants who did not have any occupation (AOR=3.409, 95% CI: 1.120 to 10.374) and presence of comorbid conditions (AOR=2.004, 95% CI: 1.095 to 3.668) were predictors of DRH. CONCLUSION Nearly 90% of DRH was deemed to be preventable in the study settings. Older age, lower educational level, unemployment and presence of comorbid conditions in hospital as an inpatient were predictors of DRH.
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Affiliation(s)
- Mulate Belete Demessie
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemseged Beyene Berha
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Laureau M, Vuillot O, Gourhant V, Perier D, Pinzani V, Lohan L, Faucanie M, Macioce V, Marin G, Giraud I, Jalabert A, Villiet M, Castet-Nicolas A, Sebbane M, Breuker C. Adverse Drug Events Detected by Clinical Pharmacists in an Emergency Department: A Prospective Monocentric Observational Study. J Patient Saf 2021; 17:e1040-e1049. [PMID: 32175969 DOI: 10.1097/pts.0000000000000679] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Adverse drug events (ADEs) are a major public health issue in hospitals. They are difficult to detect because of incomplete or unavailable medication history. In this study, we aimed to assess the rate and characteristics of ADEs identified by pharmacists in an emergency department (ED) to identify factors associated with ADEs. METHODS In this prospective observational study, we included consecutive adult patients presenting to the ED of a French 2600-bed tertiary care university hospital from November 2011 to April 2015. Clinical pharmacists conducted structured interviews and collected the medication history to detect ADEs (i.e., injuries resulting directly or indirectly from adverse drug reactions and noncompliance to medication prescriptions). Unsure ADE cases were reviewed by an expert committee. Relations between patient characteristics, type of ED visit, and ADE risk were analyzed using logistic regression. RESULTS Among the 8275 included patients, 1299 (15.7%) presented to the ED with an ADE. The major ADE symptoms were bleeding, endocrine problems, and neurologic disorders. Moreover, ADEs led to the ED visit, hospitalization, and death in 87%, 49.3%, and 2.2% of cases, respectively. Adverse drug event risk was independently associated with male sex, ED visit for neurological symptoms, visit to the ED critical care unit, or ED short stay hospitalization unit, use of blood, anti-infective, antineoplastic, and immunomodulating drugs. CONCLUSIONS This study improves the knowledge about ADE characteristics and on the patients at risk of ADE. This could help ED teams to better identify and manage ADEs and to improve treatment quality and safety.
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Mouton JP, Jobanputra N, Njuguna C, Gunter H, Stewart A, Mehta U, Lahri S, Court R, Igumbor E, Maartens G, Cohen K. Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence. Afr J Emerg Med 2021; 11:46-52. [PMID: 33437593 PMCID: PMC7787921 DOI: 10.1016/j.afjem.2020.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/22/2020] [Accepted: 10/19/2020] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION South Africa has the world's largest antiretroviral treatment programme, which may contribute to the adverse drug reaction (ADR) burden. We aimed to determine the proportion of adult non-trauma emergency unit (EU) presentations attributable to ADRs and to characterise ADR-related EU presentations, stratified according to HIV status, to determine the contribution of drugs used in management of HIV and its complications to ADR-related EU presentations, and identify factors associated with ADR-related EU presentation. METHODS We conducted a retrospective folder review on a random 1.7% sample of presentations over a 12-month period in 2014/2015 to the EUs of two hospitals in Cape Town, South Africa. We identified potential ADRs with the help of a trigger tool. A multidisciplinary panel assessed potential ADRs for causality, severity, and preventability. RESULTS We included 1010 EU presentations and assessed 80/1010 (7.9%) as ADR-related, including 20/239 (8.4%) presentations among HIV-positive attendees. Among HIV-positive EU attendees with ADRs 17/20 (85%) were admitted, versus 22/60 (37%) of HIV-negative/unknown EU attendees. Only 5/21 (24%) ADRs in HIV-positive EU attendees were preventable, versus 24/63 (38%) in HIV-negative/unknown EU attendees. On multivariate analysis, only increasing drug count was associated with ADR-related EU presentation (adjusted odds ratio 1.10 per additional drug, 95% confidence interval 1.03 to 1.18), adjusted for age, sex, HIV status, comorbidity, and hospital. CONCLUSIONS ADRs caused a significant proportion of EU presentations, similar to findings from other resource-limited settings. The spectrum of ADR manifestations in our EUs reflects South Africa's colliding epidemics of infectious and non-communicable diseases. ADRs among HIV-positive EU attendees were more severe and less likely to be preventable.
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A Prospective Observational Study of Drug Therapy Problems in Pediatric Ward of a Referral Hospital, Northeastern Ethiopia. Int J Pediatr 2020; 2020:4323189. [PMID: 32256614 PMCID: PMC7115047 DOI: 10.1155/2020/4323189] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/21/2019] [Accepted: 01/23/2020] [Indexed: 12/01/2022] Open
Abstract
Background A drug therapy problem is any undesirable event experienced by a patient during drug therapy that interferes with achieving the desired goals of therapy. It has been pointed out that hospitalized pediatric patients are particularly prone to drug-related problems. Identifying drug therapy problems enables risk quantification and determination of the potential impact of prevention strategies. The purpose of this study was to assess the drug therapy problems in a pediatric ward of Dessie Referral Hospital, northeast of Ethiopia, and to identify associated factors for drug therapy problems. Methods A prospective observational study design was carried out to assess drug therapy problems in a pediatric ward of Dessie Referral Hospital from February 1, 2018, to May 30, 2018. Ethical approval was obtained, and informed consent was signed by each study participant's parent before the commencement of the study. All patients admitted to the ward during the study period were included in the study. Data was collected by trained pharmacy staffs through medical record reviews of patients using a prepared standard checklist and semistructured questionnaire. The collected data were cleared and checked every day for completeness and consistency before processing. Data were entered, and descriptive statistical analysis was done using SPSS Version 20 Software. A P value of less than 0.05 was considered significant. Results The participants' mean age was 2.32 years with the standard deviation (SD) of 0.76 years. Among 81 patients, 71 (87.7%) of them had at least one drug therapy problem per patient which indicates that the prevalence of the drug therapy problem was substantially high. Needs additional drug was the most predominantly encountered drug therapy problem accounted (30 (25.2%)). On the other hand, ineffective drug was the least (3 (2.5%)) drug therapy problem. Antibiotics (47 (39.5%)) followed by fluid and electrolyte (25 (21%)) were classes of drugs mostly involved in the drug therapy problem. The main risk factors reported to the occurrence of the drug therapy problems were prescribing and dose calculation errors. Conclusion The present study revealed that majority of the patients had at least one DTP per patient; this indicates that prevalence of DTP was very high in the study area. Needs additional drug therapy followed by noncompliance was the major cause of the occurrence of DTP. Antibiotics were the main class of drugs involved in the drug therapy problem, and among the risk factors assessed, prescribing and dose calculation errors showed statistical significance.
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Abdulmalik H, Tadiwos Y, Legese N. Assessment of drug-related problems among type 2 diabetic patients on follow up at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. BMC Res Notes 2019; 12:771. [PMID: 31771634 PMCID: PMC6880367 DOI: 10.1186/s13104-019-4760-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/24/2019] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To assess the drug-related problem among patients with type 2 diabetes at Hiwot Fana Specialized University Hospital. RESULTS In this study, a total of 148 patient medication records were included. More than half, 83 (57.4%) were men and the rest 65 (42.6%) were women. The mean age of the study participants was 51.26 ± 7.08. Around one-third (74.3%) of the participants had urban residency. A total of 127 drug-related problems were identified, of which dosage too low was the most common type of DRP encountered, 46 (36.2%), followed by unnecessary drug therapy, 25 (19.7%) and ineffective drug therapy, 25 (19.7%). 95 (64.2%) of the patients had at least one drug-related problem. Among patients with DRP, more than half of them, 59 (62.1%) had a single DRP. Out of the total participants, 85 (57.4%) of them were taking one anti-diabetic medication and 63 (42.6%) of them dual anti-diabetic medications. Only half of the patients have attained the desired FBG level. There was no patient who had experienced more than two types of drug-related problems at a time. Less than 10% of patients were taking five or more drugs at a time.
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Affiliation(s)
- Haymen Abdulmalik
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Yohannes Tadiwos
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
| | - Nanati Legese
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
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Ruiz-Garzon JA, Rojas-Velandia CA, Calderon-Ospina CA. Drug Therapeutic Failures as a Cause of Admission to an Intensive Care Unit at a University Hospital. J Res Pharm Pract 2019; 8:168-172. [PMID: 31728349 PMCID: PMC6830022 DOI: 10.4103/jrpp.jrpp_18_69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/20/2019] [Indexed: 11/04/2022] Open
Abstract
Objective Drug therapeutic failures (TFs) are included in pharmacovigilance reporting, as some authors consider them a type of adverse drug reaction. Given their high frequency in Colombia, we studied their importance as a cause of admission to an intensive care unit (ICU). Methods This was a cross-sectional observational study. Clinical records of patients who arrived at the emergency service of a third-care level university hospital were reviewed. Information was collected by a resident in clinical toxicology, and each case was validated and analyzed by a research team using the algorithm proposed by Vaca González and Schumock and Thornton criteria for preventability to evaluate the existence of possible medication errors. Findings In total, 697 clinical records were evaluated and 18 patients presented TFs (2.6%, 95% confidence interval 1.5%-4.1%) as the cause of admission to the ICU. The most frequent TFs were seizures (56%) and hypertension (28%). The most commonly associated medications were valproic acid (28%) and losartan (28%). Ten cases (56%) were associated with drug misuse and the same number of cases was preventable, according to Schumock and Thornton criteria. Conclusion This is the first study assessing TFs as a cause of admission to the ICU in the Colombian population. The frequency of TFs in our study was similar to that described in the literature; being the most common cause the inappropriate drug use, particularly for drugs with complex kinetics, such as antiepileptic drugs.
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Affiliation(s)
| | | | - Carlos-Alberto Calderon-Ospina
- Department of Biomedical Sciences, Pharmacology Unit, Universidad del Rosario, Bogotá, Colombia.,Center for Research in Genetics and Genomics, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
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Konuru V, Naveena B, Sneha Reddy E, Vivek BC, Shravani G. A Prospective Study on Hospitalization due to Drug-related Problems in a Tertiary Care Hospital. J Pharm Bioallied Sci 2019; 11:328-332. [PMID: 31619914 PMCID: PMC6791085 DOI: 10.4103/jpbs.jpbs_35_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Drug-related problem (DRP) is any undesirable event experienced by the patient, which is suspected to involve drug therapy and interferes with a desired patient outcome. Most of these DRPs are avoidable with little vigilant effort. DRP admissions need high attention as DRP-related admissions on an average accounted for 8.36%, of which 50% are avoidable. The aim of the study was to identify the risk factors associated with DRPs in tertiary care hospital. Materials and Methods One year prospective observational study was conducted in the departments of general medicine, dermatology, pediatrics, and gastroenterology of a tertiary care teaching hospital. A total of 148 cases, where a correlation between past medication history and current complaints was established, were included in the study. Exclusion criteria of the study were no correlation between past medication history and current complaints, social habits causing hospitalization, and herbal medication use history. Results and Discussion In this study, nonadherence (50.94%) and adverse drug reaction (ADR) (38.36%) were predominant among the identified DRPs. Children and geriatrics showed the higher incidence of nonadherence to the prescribed therapy. ADRs were the DRP with the higher incidence among adults followed by nonadherence to the prescribed therapy. Lack of knowledge about the disease, its complications, and possible adverse reactions with self-medication was identified to be the high incidence risk factor. Higher incidence of DRPs was observed in patients having a past medical history of cardiovascular system and central nervous system diseases, which require long-term management. Conclusion In this study, nonadherence to prescribed therapy was found to be the DRP causing hospitalization at a higher incidence. The most commonly involved risk factors were lack of knowledge about the disease, need of adherence to the therapy as prescribed, and outcomes of the treatment provided.
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Affiliation(s)
- Venkateswarlu Konuru
- Department of Pharmacy Practice/Pharm D, CMR College of Pharmacy, Hyderabad, Telangana, India
| | - Bodanam Naveena
- Department of Pharmacy Practice/Pharm D, CMR College of Pharmacy, Hyderabad, Telangana, India
| | - Edulakanti Sneha Reddy
- Department of Pharmacy Practice/Pharm D, CMR College of Pharmacy, Hyderabad, Telangana, India
| | - Bandela Charles Vivek
- Department of Pharmacy Practice/Pharm D, CMR College of Pharmacy, Hyderabad, Telangana, India
| | - Gyadari Shravani
- Department of Pharmacy Practice/Pharm D, CMR College of Pharmacy, Hyderabad, Telangana, India
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Lo Giudice I, Mocciaro E, Giardina C, Barbieri MA, Cicala G, Gioffrè-Florio M, Carpinteri G, Di Grande A, Spina E, Arcoraci V, Cutroneo PM. Characterization and preventability of adverse drug events as cause of emergency department visits: a prospective 1-year observational study. BMC Pharmacol Toxicol 2019; 20:21. [PMID: 31029178 PMCID: PMC6486973 DOI: 10.1186/s40360-019-0297-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 04/05/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Adverse drug events (ADEs) are a significant cause of emergency department (ED) visits, with a major impact on healthcare resource utilization. A multicentre observational study, aimed to describe frequency, seriousness and preventability of ADEs reported in four EDs, was performed in Sicily (Italy) over a 1-year period. METHODS Two trained monitors for each ED supported clinicians in identifying ADEs of patients admitted to EDs between June 1st, 2013 and May 31st, 2014 through a systematic interview of patients or their caregivers and with an additional record review. A research team analyzed each case of suspected ADE, to make a causality assessment applying the Naranjo algorithm and a preventability assessment using Schumock and Thornton criteria. Absolute and percentage frequencies with 95% confidence interval (CI) and medians with interquartile ranges (IQR) were estimated. Logistic regression models were used to evaluate independent predictors of serious and certainly preventable ADEs. RESULTS Out of 16,963 ED visits, 575 (3.4%) were associated to ADEs, of which 15.1% resulted in hospitalization. ADEs were classified as probable in 45.9%, possible in 51.7% and definite in 2.4% of the cases. Moreover, ADEs were considered certainly preventable in 12.3%, probably preventable in 58.4%, and not preventable in 29.2% of the cases. Polytherapy influenced the risk to experience a serious, as well as a certainly preventable ADE. Whilst, older age resulted an independent predictor only of serious events. The most common implicated drug classes were antibiotics (34.4%) and anti-inflammatory drugs (22.6%). ADEs due to psycholeptics and antiepileptics resulted preventable in 62.7 and 54.5% of the cases, respectively. Allergic reactions (64%) were the most frequent cause of ADE-related ED visits, followed by neurological effects (10.2%) that resulted preventable in 1.9 and 37.3% of the cases, respectively. CONCLUSION ADEs are a frequent cause of ED visits. The commonly used antibiotics and anti-inflammatory drugs should be carefully managed, as they are widely involved in mild to severe ADEs. Polytherapy is associated with the occurrence of serious, as well as certainly preventable ADEs, while older age only with serious events. A greater sensitivity to drug monitoring programs among health professionals is needed.
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Affiliation(s)
- Ivan Lo Giudice
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy
| | - Eleonora Mocciaro
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy
| | - Claudia Giardina
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy
| | - Maria Antonietta Barbieri
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy
| | - Giuseppe Cicala
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy
| | - Maria Gioffrè-Florio
- Department of Emergency Medicine, University Hospital G. Martino, Via Consolare Valeria, 98125, Messina, Italy
| | - Giuseppe Carpinteri
- Department of Emergency Medicine, University Hospital V. Emanuele, Via S. Sofia, 95123, Catania, Italy
| | - Aulo Di Grande
- Department of Emergency Medicine, General Hospital S. Elia, Via Luigi Russo, 93100, Caltanissetta, Italy
| | - Edoardo Spina
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy
- Sicilian Regional Pharmacovigilance Center, Clinical Pharmacology Unit, University Hospital G. Martino, Via Consolare Valeria, 98125, Messina, Italy
| | - Vincenzo Arcoraci
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125, Messina, Italy.
| | - Paola Maria Cutroneo
- Sicilian Regional Pharmacovigilance Center, Clinical Pharmacology Unit, University Hospital G. Martino, Via Consolare Valeria, 98125, Messina, Italy
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Nagai KL, Takahashi PSK, Pinto LMDO, Romano-Lieber NS. Use of triggers tools to search for adverse drug reactions in the elderly admitted to emergency departments. CIENCIA & SAUDE COLETIVA 2018; 23:3997-4006. [PMID: 30427469 DOI: 10.1590/1413-812320182311.27022016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 11/30/2016] [Indexed: 11/22/2022] Open
Abstract
Adverse drug reactions (ADRs) can cause illness, disability or death, especially in the elderly. An active search for suspected ADRs was carried out using triggers, which motivated the search of elderly people under care in adult emergency departments (ED). It was a cross-sectional and retrospective study that used an adaptation of the Institute of Health Care Improvement triggers. A total of 287 medical records were analyzed and 38 triggers were found, identifying 7 suspected ADRs. One was found without the use of triggers. Thus, in total, 8 ADRs (2.79%) were found, of which 6 were considered serious. There was a higher prevalence of ADRs in females (62.5%) and in those over 80 years of age (50%). The medications most implicated were those for alimentary tract and metabolism and cardiovascular system. Of the triggers tested, some are essential for use at EDs, such as those that indicate problems with anticoagulants, hypoglycemic agents and antihypertensives. Triggers have proved useful for an active search for suspected ADRs at EDs, including severe ones, identifying problems occurring outside hospital settings and signaling medications that pose an increased risk to the elderly .
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Affiliation(s)
- Kelly Lie Nagai
- Hospital Universitário de São Paulo , Universidade de São Paulo (USP). Av. Prof. Lineu Prestes 2565, Butantã. 05508-000 São Paulo SP Brasil .
| | - Patricia Sayuri Katayose Takahashi
- Hospital Universitário de São Paulo , Universidade de São Paulo (USP). Av. Prof. Lineu Prestes 2565, Butantã. 05508-000 São Paulo SP Brasil .
| | - Lucia Mendes de Oliveira Pinto
- Hospital Universitário de São Paulo , Universidade de São Paulo (USP). Av. Prof. Lineu Prestes 2565, Butantã. 05508-000 São Paulo SP Brasil .
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Tramontina MY, Ferreira MB, Castro MSD, Heineck I. Comorbidities, potentially dangerous and low therapeutic index medications: factors linked to emergency visits. CIENCIA & SAUDE COLETIVA 2018; 23:1471-1482. [PMID: 29768602 DOI: 10.1590/1413-81232018235.07512016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 07/22/2016] [Indexed: 01/10/2023] Open
Abstract
This article aims to investigate the morbidities related to medications, their risk factors and causes detected in patients who seek the Hospital Emergency Service of a University in the South of Brazil. Data collection was based on application of a questionnaire to patients of a minimum age of 18 years, that signing the Term of Free and Informed Consent (TFIC), during the period from October 2013 to March 2014, and analysis of electronic record charts. Cases were evaluated by pharmacists and a doctor to define whether it was a case of medication related morbidity (MRM) and to establish its possible causes. Avoidability of MRM was verified based on criteria previously established in the literature. In total 535 patients were interviewed, and the frequency of MRM was 14.6%, Approximately 45% of MRMs were related to safety in the use of medications, and approximately 50% presented user-related questions as the possible cause. Hospitalization was required in 44.8% of MRM cases; 62.7% of cases were considered avoidable. Presence of chronic disease and use of potentially dangerous medication and low therapeutic index were considered independent factors associated with development of MRM, according to statistical analysis.
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Affiliation(s)
- Mariana Younes Tramontina
- Programa de Pós-Graduação em Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS). Av. Ipiranga 2752, Azenha. 90610-000 Porto Alegre RS Brasil.
| | - Maria Beatriz Ferreira
- Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, UFRGS. Porto Alegre RS Brasil
| | - Mauro Silveira de Castro
- Programa de Pós-Graduação em Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS). Av. Ipiranga 2752, Azenha. 90610-000 Porto Alegre RS Brasil.
| | - Isabela Heineck
- Programa de Pós-Graduação em Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS). Av. Ipiranga 2752, Azenha. 90610-000 Porto Alegre RS Brasil.
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Sagita VA, Bahtiar A, Andrajati R. Evaluation of a Clinical Pharmacist Intervention on Clinical and Drug-Related Problems Among Coronary Heart Disease Inpatients: A pre-experimental prospective study at a general hospital in Indonesia. Sultan Qaboos Univ Med J 2018; 18:e81-e87. [PMID: 29666686 DOI: 10.18295/squmj.2018.18.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/07/2017] [Accepted: 10/26/2017] [Indexed: 01/19/2023] Open
Abstract
Objectives This study aimed to evaluate the role of a clinical pharmacist intervention in decreasing subsequent clinical and drug-related problems (DRPs) among coronary heart disease (CHD) inpatients with at least one previous DRP. Methods This pre-experimental study with a pre-post design was carried out from January to April 2017 among inpatients with at least one previous DRP at a general hospital in Tangerang District, Banten, Indonesia. Clinical and DRPs were documented prospectively by a clinical pharmacist, with DRPs classified using Version 6.2 of the DRP classification scheme of the Pharmaceutical Care Network Europe Foundation. The intervention consisted of a discussion of identified DRPs with physicians, patients, pharmaceutical logistics clerks, nurses and nutritionists. Following this, any subsequent clinical and DRPs were re-identified and further interventions were conducted as necessary. Results A total of 75 inpatients were included in the study. Pre-intervention, there were 443 DRPs and 202 clinical problems. The most frequent DRPs were adverse drug reactions (52.6%), followed by drug effects (41.8%). Most DRPs were of moderate severity and would have resulted in moderate consequences had the pharmacist not intervened. The interventions resulted in a significant reduction in the number of DRPs, type of DRPs and number of clinical problems (P <0.05 each). Patients with complications were 26.047 times more likely to have no reduction or an increased number of clinical problems compared to patients without complications (P <0.05). Conclusion Clinical pharmacist interventions were found to reduce subsequent DRPs and clinical problems among CHD patients with at least one previous DRP.
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Affiliation(s)
- Vina A Sagita
- Faculty of Pharmacy, University of Indonesia, Depok, West Java, Indonesia
| | - Anton Bahtiar
- Department of Pharmaceuticals, University of Indonesia, Depok, West Java, Indonesia
| | - Retnosari Andrajati
- Department of Pharmaceuticals, University of Indonesia, Depok, West Java, Indonesia
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Freitas GRMD, Tramontina MY, Balbinotto G, Hughes DA, Heineck I. Economic Impact of Emergency Visits due to Drug-Related Morbidity on a Brazilian Hospital. Value Health Reg Issues 2017; 14:1-8. [DOI: 10.1016/j.vhri.2017.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 09/29/2016] [Accepted: 03/01/2017] [Indexed: 11/29/2022]
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Al Hamid AM, Ghaleb M, Aljadhey H, Aslanpour Z. Factors contributing to medicine-related problems in adult patients with diabetes and/or cardiovascular diseases in Saudi Arabia: a qualitative study. BMJ Open 2017; 7:e017664. [PMID: 29133322 PMCID: PMC5695315 DOI: 10.1136/bmjopen-2017-017664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/09/2017] [Accepted: 08/16/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To investigate the factors contributing to medicine-related problems (MRPs) among patients with cardiovascular diseases (CVDs) and/or diabetes in Saudi Arabia. DESIGN Qualitative semistructured interviews were conducted. Interviews were audio recorded then transcribed into Microsoft Word. The transcribed interviews were then imported into the qualitative analysis software NVivo where thematic analysis was applied. Thematic synthesis was achieved by coding and developing subthemes/themes from the findings of the interviews. SETTING Five healthcare centres in Najran, Saudi Arabia. PARTICIPANTS 25 adult patients with diabetes and/or CVDs. RESULTS The study cohort included 16 men and 9 women with a median age of 61.8 years (40-85 years). Diabetes was the main condition encountered among 23 patients and CVDs were reported among 18 patients. Perceived factors leading to MRPs were of four types and related to: patient-, healthcare system-, clinical (condition-) and medicine-related factors. Patient-related factors were related to living situation, religious practices, diet/exercise and patients' behaviour towards the condition and medicines. Healthcare system-related factors comprised sources and availability of medicines, ease of access to healthcare system and patient satisfaction with healthcare providers. Clinical (condition-) related factors associated with both the knowledge and control over condition, and effects of the condition among medicines intake. Medicine-related factors included lack of knowledge about medicines and medicine use. CONCLUSIONS The results of this study uncovered many factors associated with MRPs among patients with CVDs and diabetes in Saudi Arabia, especially in reference to lifestyle and medicine use. Improving communication with healthcare professional alongside the introduction of national clinical guidance would mitigate the unwanted health complications related to medicine use.
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Affiliation(s)
- Abdullah Mahdi Al Hamid
- Department of Pharmacy, Pharmacology and Postgraduate Medicine, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Maisoon Ghaleb
- Department of Pharmacy, Pharmacology and Postgraduate Medicine, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Hisham Aljadhey
- College of Pharmacy, King Saud University, Riyadh, Riyadh, Saudi Arabia
| | - Zoe Aslanpour
- Department of Pharmacy, Pharmacology and Postgraduate Medicine, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
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Polypharmacy and potential drug-drug interactions in emergency department patients in the Caribbean. Int J Clin Pharm 2017; 39:1119-1127. [PMID: 28795285 PMCID: PMC5686268 DOI: 10.1007/s11096-017-0520-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 08/02/2017] [Indexed: 10/31/2022]
Abstract
Background Potential Drug-Drug Interactions (DDI) account for many emergency department visits. Polypharmacy, as well as herbal, over-the-counter (OTC) and combination medication may compound this, but these problems are not well researched in low-and-middle-income countries. Objective To compare the incidence of drug-drug interactions and polypharmacy in older and younger patients attending the Emergency Department (ED). Setting The adult ED of a tertiary teaching hospital in Trinidad. Methods A 4 month cross sectional study was conducted, comparing potential DDI in older and younger patients discharged from the ED, as defined using Micromedex 2.0. Main outcome measure The incidence and severity of DDI and polypharmacy (defined as the use of ≥5 drugs simultaneously) in older and younger patients attending the ED. Results 649 patients were included; 275 (42.3%) were ≥65 years and 381 (58.7%) were female. There were 814 DDIs, of which 6 (.7%) were contraindications and 148 (18.2%) were severe. Polypharmacy was identified in 244 (37.6%) patients. Older patients were more likely to have potential DDI (67.5 vs 48.9%) and polypharmacy (56 vs 24.1%). Herbal products, OTC and combination drugs were present in 8, 36.7 and 22.2% of patients, respectively. On multivariate analysis, polypharmacy and the presence of hypertension and ischaemic heart disease were associated with an increased risk of potential DDI. Conclusion Polypharmacy and potential drug-drug interactions are common in ED patients in the Caribbean. Older patients are particularly at risk, especially as they are more likely to be on multiple medications. The association between herbal medication and polypharmacy needs further investigation. This study indicates the need for a more robust system of drug reconciliation in the Caribbean.
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Girgin MC, Yanturali S, Arici MA, Çolak Oray N, Doylan Ö, Demiral Y, Tunçok Y. Emergency department visits caused by adverse drug reactions: results of aTurkish university hospital. Turk J Med Sci 2016; 46:945-52. [PMID: 27513388 DOI: 10.3906/sag-1503-14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 08/22/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM We aimed to evaluate adverse drug reaction (ADR)-related emergency department (ED) visits in the ED of the Dokuz Eylül University Hospital prospectively. MATERIALS AND METHODS Patients who were admitted to the ED during 1-week periods of four different seasons between July 2010 and April 2011 were enrolled. Demographics of patients, previous ADR history, clinical progress, and outcomes were recorded. Causality assessment was done according to World Health Organization Uppsala Monitoring Centre categories. ADRs were categorized as certain, probable, or possible. RESULTS Patients who were on medications (26.5%, n = 1838) were evaluated for ADR-related ED admissions. ADRs accounted for 5.9% of cases (n = 108). The most frequently affected systems were the gastrointestinal (35.2%, n = 38), dermatological (23.1%, n = 25), and hematological (10.2%, n = 11) systems (7.4%, n = 8). The most common causes of ADRs were antiinfectives (31.6%, n = 33). Amoxicillin, Coumadin, and paracetamol were the most common medications that caused ADRs. CONCLUSION Nearly 6% of the admissions were ADR-related. ADRs should always be considered when patients who are on medication are admitted to the ED. Multicenter epidemiologic studies are required to know the real rates of ADR cases in EDs in Turkey.
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Affiliation(s)
- Mehmet Can Girgin
- Emergency Medicine Clinic, İstanbul Education and Research Hospital, İstanbul, Turkey
| | - Sedat Yanturali
- Department of Emergency Medicine, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Mualla Aylin Arici
- Department of Pharmacology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Neşe Çolak Oray
- Department of Emergency Medicine, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Özgür Doylan
- Department of Emergency Medicine, Faculty of Medicine, Ahi Evran University Education Research Hospital, Kırşehir, Turkey
| | - Yücel Demiral
- Department of Public Health, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Yeşim Tunçok
- Department of Pharmacology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
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Development of an Aggregated System for Classifying Causes of Drug-Related Problems. Ann Pharmacother 2015; 49:405-18. [DOI: 10.1177/1060028014568008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: More than 20 different types of classification systems for drug-related problems (DRPs) and their causes have been developed. Classification is necessary to describe and assess clinical, organizational, and economic impacts of DRPs through documentation of collected data. However, many researchers have judged classification systems incomplete when describing their data, and have modified them or developed their own. This variability between systems has made study comparisons difficult. Objectives: To perform a category-by-category comparison of the content of selected DRP classification systems to construct an aggregated cause-of-DRP classification system containing the content of all systems. Method: DRP classification systems were identified after a literature review, with 7 chosen based on their use in varied health care settings, geographical diversity, frequency of use, and method of development. These systems were critically analyzed, and the content of each category was compared and aggregated where appropriate. A hierarchy of categories was constructed to include all content from all systems. Any modifications that previous studies may have made to the 7 systems were also cross-referenced to ensure that no concepts were missing from the newly aggregated system. Clinical examples to optimize application, and instructions for when or when not to use categories, were developed. Interrater agreement for classification of the causes of DRPs from 10 medication reviews was performed between 3 clinical pharmacists and the authors’ gold standard. Results: We found variation in developmental methods, category descriptions, number and types of categories, and validation methods between the 7 selected systems, together with intermingling of categories identified as causes of DRPs with DRPs themselves. A hierarchical classification system was constructed consisting of 9 cause-of-DRP categories, 33 subcategories, and 58 sub-subcategories, for which interrater agreements were 82.5%, 74.6%, and 58.8%, respectively. Conclusion: An aggregated classification system was constructed through a unique and transparent developmental process that may provide the most comprehensive description of causes of DRPs to date. This may facilitate teaching of pharmaceutical care, comparisons of clinical practice, and measurement of the effectiveness of pharmaceutical care interventions.
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Perrone V, Conti V, Venegoni M, Scotto S, Degli Esposti L, Sangiorgi D, Prestini L, Radice S, Clementi E, Vighi G. Seriousness, preventability, and burden impact of reported adverse drug reactions in Lombardy emergency departments: a retrospective 2-year characterization. CLINICOECONOMICS AND OUTCOMES RESEARCH 2014; 6:505-14. [PMID: 25506231 PMCID: PMC4259870 DOI: 10.2147/ceor.s71301] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The purpose of this study was to determine the prevalence of adverse drug reactions (ADRs) reported in emergency departments (EDs) and carry out a thorough characterization of these to assess preventability, seriousness that required hospitalization, subsequent 30-day mortality, and economic burden. Methods This was a retrospective cohort study of data from an active pharmacovigilance project at 32 EDs in the Lombardy region collected between January 1, 2010 and December 31, 2011. Demographic, clinical, and pharmacological data on patients admitted to EDs were collected by trained and qualified monitors, and deterministic record linkage was performed to estimate hospitalizations. Pharmacoeconomic analyses were based on Diagnosis-Related Group reimbursement. Results 8,862 ADRs collected with an overall prevalence rate of 3.5 per 1,000 visits. Of all ADRs, 42% were probably/definitely preventable and 46.4% were serious, 15% required hospitalization, and 1.5% resulted in death. The System Organ Classes most frequently associated with ADRs were: skin and subcutaneous tissue, gastrointestinal, respiratory thoracic and mediastinal, and nervous system disorders. The most common Anatomical Therapeutic Chemical classes involved in admissions were J (anti-infectives and immunomodulating agents), B (blood and blood-forming organs), and N (nervous system). Older age, yellow and red triage, higher number of concomitantly taken drugs, and previous attendance in ED for the same ADR were significantly associated with an increased risk of hospitalization. The total cost associated with ADR management was €5,184,270, with a mean cost per patient of €585. Fifty-eight percent of the economic burden was defined as probably/definitely preventable. Conclusion ADRs are a serious health/economic issue in EDs. This assessment provides a thorough estimation of their seriousness, preventability, and burden impact in a large population from a representative European region.
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Affiliation(s)
- Valentina Perrone
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital Luigi Sacco, Università di Milano, Milan, Italy
| | - Valentino Conti
- Regional Centre for Pharmacovigilance, Lombardy, Milan, Italy
| | - Mauro Venegoni
- Regional Centre for Pharmacovigilance, Lombardy, Milan, Italy
| | - Stefania Scotto
- Regional Centre for Pharmacovigilance, Lombardy, Milan, Italy
| | | | - Diego Sangiorgi
- CliCon Srl, Health, Economics and Outcomes Research, Ravenna, Italy
| | - Lucia Prestini
- Unit of Clinical Pharmacology and Pharmacovigilance, Niguarda Ca'Granda Hospital, Milan, Italy
| | - Sonia Radice
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital Luigi Sacco, Università di Milano, Milan, Italy
| | - Emilio Clementi
- Unit of Clinical Pharmacology, CNR Institute of Neuroscience, Department of Biomedical and Clinical Sciences, University Hospital Luigi Sacco, Università di Milano, Milan, Italy ; Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Giuseppe Vighi
- Regional Centre for Pharmacovigilance, Lombardy, Milan, Italy ; Unit of Clinical Pharmacology and Pharmacovigilance, Niguarda Ca'Granda Hospital, Milan, Italy
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Al Hamid A, Ghaleb M, Aljadhey H, Aslanpour Z. A systematic review of hospitalization resulting from medicine-related problems in adult patients. Br J Clin Pharmacol 2014; 78:202-17. [PMID: 24283967 PMCID: PMC4137816 DOI: 10.1111/bcp.12293] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 11/13/2013] [Indexed: 12/23/2022] Open
Abstract
AIMS Medicine-related problems (MRPs) represent a major issue leading to hospitalization, especially in adult and elderly patients. The aims of this review are to investigate the prevalence, causes and major risk factors for MRPs leading to hospitalization in adult patients and to identify the main medicine classes involved. METHODS Studies were identified through electronic searches of Medline, Embase, Scopus and International Pharmaceutical Abstracts between January 2000 and May 2013. A systematic review was conducted of both retrospective and prospective studies. Studies included were those involving hospitalization resulting from MRPs in adults (≥18 years old), whereas studies excluded were those investigating drug misuse and abuse and studies investigating MRPs in hospitalized patients. Data analysis was performed using SPSS version 20. RESULTS Forty-five studies were identified, including 21 that investigated hospitalization resulting from adverse drug reactions, six studies that investigated hospitalization due to adverse drug events and 18 studies that investigated hospitalization due to MRPs. The median prevalence rates of hospitalization resulting from adverse drug reactions, adverse drug events and MRPs were 7% (interquartile range, 2.4-14.9%), 4.6% (interquartile range, 2.85-16.6%) and 12.1% (interquartile range, 6.43-22.2%), respectively. The major causes contributing to MRPs were adverse drug reactions and noncompliance. In addition, the major risk factors associated with MRPs were old age, polypharmacy and comorbidities. Moreover, the main classes of medicines implicated were medicines used to treat cardiovascular diseases and diabetes. CONCLUSIONS Hospitalization due to MRPs had a high prevalence, in the range of 4.6-12.1%. Most MRPs encountered were prevalent among adult patients taking medicines for cardiovascular diseases and diabetes.
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Affiliation(s)
- Abdullah Al Hamid
- Department of Pharmacy, School of Life and Medical Sciences, University of HertfordshireHatfield, UK
| | - Maisoon Ghaleb
- Department of Pharmacy, School of Life and Medical Sciences, University of HertfordshireHatfield, UK
| | - Hisham Aljadhey
- College of Pharmacy, King Saud UniversityRiyadh, Saudi Arabia
| | - Zoe Aslanpour
- Department of Pharmacy, School of Life and Medical Sciences, University of HertfordshireHatfield, UK
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Basger BJ, Moles RJ, Chen TF. Application of drug-related problem (DRP) classification systems: a review of the literature. Eur J Clin Pharmacol 2014; 70:799-815. [DOI: 10.1007/s00228-014-1686-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/16/2014] [Indexed: 11/28/2022]
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Sperandio da Silva GM, Chambela MC, Sousa AS, Sangenis LHC, Xavier SS, Costa AR, Brasil PEAA, Hasslocher-Moreno AM, Saraiva RM. Impact of pharmaceutical care on the quality of life of patients with Chagas disease and heart failure: randomized clinical trial. Trials 2012; 13:244. [PMID: 23270509 PMCID: PMC3543334 DOI: 10.1186/1745-6215-13-244] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 12/17/2012] [Indexed: 11/21/2022] Open
Abstract
Background Pharmaceutical care is the direct interaction between pharmacist and patient, in order to improve therapeutic compliance, promote adequate pharmacotherapeutic follow-up, and improve quality of life. Pharmaceutical care may be effective in reducing complications and in improving the quality of life of patients with chronic diseases, like Chagas heart disease, while bringing a positive impact on health system costs. The morbidity and mortality indexes for patients with Chagas heart disease are high, especially if this heart disease is complicated by heart failure. In this setting, we hypothesize that pharmaceutical care might be an important tool for the clinical management of these patients by improving their quality of life, as a better compliance to their treatment and the avoidance and prompt correction of drug-related problems will minimize their symptoms, improve their functional class, and decrease the number of hospital admissions. Therefore, the aim of this trial is to evaluate the contribution of pharmaceutical care to clinical treatment of patients with Chagas heart disease complicated by heart failure. Methods/design A prospective, single-center randomized clinical trial will be conducted in patients with Chagas heart disease complicated by heart failure. A total of 88 patients will be randomly assigned into two parallel groups: an intervention group will receive standard care and pharmaceutical care, and a control group will receive only standard care. Both groups will be subjected to a follow-up period of 12 months. The primary outcome of this trial is the evaluation of quality of life, measured by the 36-item short-form and the Minnesota Living with Heart Failure Questionnaire. Secondary outcomes include drug-related problems, exercise tolerance as measured by the standard six-minute-walk test, and compliance. Discussion Patients with Chagas heart disease complicated by heart failure under pharmaceutical care are expected to improve their quality of life, present with a lower incidence of drug-related problems, improve their functional capacity, and improve in their compliance to treatment. Trial registration ClinicalTrials.gov Identifier: NCT01566617
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Affiliation(s)
- Gilberto M Sperandio da Silva
- Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Av, Brasil 4365, Rio de Janeiro, RJ, 21040-900, Brazil.
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Javier Martín-Sánchez F, Martínez Agüero M, Fernández Alonso C, González del Castillo J, Jorge González Armengol J. Eventos adversos relacionados con la medicación en los ancianos atendidos en urgencias. GACETA SANITARIA 2012; 26:585; author reply 585-6. [PMID: 22521340 DOI: 10.1016/j.gaceta.2012.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 02/15/2012] [Indexed: 11/25/2022]
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Respuesta de la autora. GACETA SANITARIA 2012. [DOI: 10.1016/j.gaceta.2012.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Julián-Jiménez A. La implantación de una guía de práctica clínica mejora los problemas relacionados con los medicamentos. GACETA SANITARIA 2012; 26:388. [DOI: 10.1016/j.gaceta.2012.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 01/13/2012] [Accepted: 01/16/2012] [Indexed: 10/28/2022]
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