Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients
Top Cited Papers
- 1 July 2004
- Vol. 329 (7456), 15-19
- https://doi.org/10.1136/bmj.329.7456.15
Abstract
Objective To ascertain the current burden of adverse drug reactions (ADRs) through a prospective analysis of all admissions to hospital. Design Prospective observational study. Setting Two large general hospitals in Merseyside, England. Participants 18 820 patients aged > 16 years admitted over six months and assessed for cause of admission. Main outcome measures Prevalence of admissions due to an ADR, length of stay, avoidability, and outcome. Results There were 1225 admissions related to an ADR, giving a prevalence of 6.5%, with the ADR directly leading to the admission in 80% of cases. The median bed stay was eight days, accounting for 4% of the hospital bed capacity. The projected annual cost of such admissions to the NHS is £466m (€706m, $847m). The overall fatality was 0.15%. Most reactions were either definitely or possibly avoidable. Drugs most commonly implicated in causing these admissions included low dose aspirin, diuretics, warfarin, and non-steroidal anti-inflammatory drugs other than aspirin, the most common reaction being gastrointestinal bleeding. Conclusion The burden of ADRs on the NHS is high, accounting for considerable morbidity, mortality, and extra costs. Although many of the implicated drugs have proved benefit, measures need to be put into place to reduce the burden of ADRs and thereby further improve the benefit:harm ratio of the drugs.Keywords
This publication has 25 references indexed in Scilit:
- Preventable Drug-Related Hospital AdmissionsAnnals of Pharmacotherapy, 2002
- Cost Effectiveness of Aspirin, Clopidogrel, or Both for Secondary Prevention of Coronary Heart DiseaseThe New England Journal of Medicine, 2002
- Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studiesInternational Journal of Clinical Pharmacy, 2002
- Ulcer complications associated with anti‐inflammatory drug use. What is the extent of the disease burden?Pharmacoepidemiology and Drug Safety, 2001
- Adverse drug reactions in hospitalized patients: A critique of a meta-analysis.2000
- Incidence of Adverse Drug Reactions in Hospitalized PatientsJAMA, 1998
- Adverse Drug Events in Hospitalized PatientsExcess Length of Stay, Extra Costs, and Attributable MortalityJAMA, 1997
- The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group.1997
- Adverse drug reactions in a hospital general medical unit meriting notification to the Committee on Safety of MedicinesBritish Journal of Clinical Pharmacology, 1996
- Prophylactic aspirin and risk of peptic ulcer bleedingBMJ, 1995