Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.

Adverse drug reactions (ADRs) are a major cause of hospital admissions, but recent data on the incidence and clinical characteristics of ADRs which occur following hospital admission, are lacking. Patients admitted to twelve wards over a six-month period in 2005 were assessed for ADRs throughout the...

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Main Authors: Emma C Davies, Christopher F Green, Stephen Taylor, Paula R Williamson, David R Mottram, Munir Pirmohamed
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2009-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0004439&type=printable
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author Emma C Davies
Christopher F Green
Stephen Taylor
Paula R Williamson
David R Mottram
Munir Pirmohamed
author_facet Emma C Davies
Christopher F Green
Stephen Taylor
Paula R Williamson
David R Mottram
Munir Pirmohamed
author_sort Emma C Davies
collection DOAJ
description Adverse drug reactions (ADRs) are a major cause of hospital admissions, but recent data on the incidence and clinical characteristics of ADRs which occur following hospital admission, are lacking. Patients admitted to twelve wards over a six-month period in 2005 were assessed for ADRs throughout their admission. Suspected ADRs were recorded and analysed for causality, severity and avoidability and whether they increased the length of stay. Multivariable analysis was undertaken to identify the risk factors for ADRs. The 5% significance level was used when assessing factors for inclusion in multivariable models. Out of the 3695 patient episodes assessed for ADRs, 545 (14.7%, 95% CI 13.6-15.9%) experienced one or more ADRs. Half of ADRs were definitely or possibly avoidable. The patients experiencing ADRs were more likely to be older, female, taking a larger number of medicines, and had a longer length of stay than those without ADRs. However, the only significant predictor of ADRs, from the multivariable analysis of a representative sample of patients, was the number of medicines taken by the patient with each additional medication multiplying the hazard of an ADR episode by 1.14 (95% CI 1.09, 1.20). ADRs directly increased length of stay in 147 (26.8%) patients. The drugs most frequently associated with ADRs were diuretics, opioid analgesics, and anticoagulants. In conclusion, approximately one in seven hospital in-patients experience an ADR, which is a significant cause of morbidity, increasing the length of stay of patients by an average of 0.25 days/patient admission episode. The overall burden of ADRs on hospitals is high, and effective intervention strategies are urgently needed to reduce this burden.
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spelling doaj-art-a13b7fe5cd37449eaef23f8d69701f482025-08-20T02:17:33ZengPublic Library of Science (PLoS)PLoS ONE1932-62032009-01-0142e443910.1371/journal.pone.0004439Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.Emma C DaviesChristopher F GreenStephen TaylorPaula R WilliamsonDavid R MottramMunir PirmohamedAdverse drug reactions (ADRs) are a major cause of hospital admissions, but recent data on the incidence and clinical characteristics of ADRs which occur following hospital admission, are lacking. Patients admitted to twelve wards over a six-month period in 2005 were assessed for ADRs throughout their admission. Suspected ADRs were recorded and analysed for causality, severity and avoidability and whether they increased the length of stay. Multivariable analysis was undertaken to identify the risk factors for ADRs. The 5% significance level was used when assessing factors for inclusion in multivariable models. Out of the 3695 patient episodes assessed for ADRs, 545 (14.7%, 95% CI 13.6-15.9%) experienced one or more ADRs. Half of ADRs were definitely or possibly avoidable. The patients experiencing ADRs were more likely to be older, female, taking a larger number of medicines, and had a longer length of stay than those without ADRs. However, the only significant predictor of ADRs, from the multivariable analysis of a representative sample of patients, was the number of medicines taken by the patient with each additional medication multiplying the hazard of an ADR episode by 1.14 (95% CI 1.09, 1.20). ADRs directly increased length of stay in 147 (26.8%) patients. The drugs most frequently associated with ADRs were diuretics, opioid analgesics, and anticoagulants. In conclusion, approximately one in seven hospital in-patients experience an ADR, which is a significant cause of morbidity, increasing the length of stay of patients by an average of 0.25 days/patient admission episode. The overall burden of ADRs on hospitals is high, and effective intervention strategies are urgently needed to reduce this burden.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0004439&type=printable
spellingShingle Emma C Davies
Christopher F Green
Stephen Taylor
Paula R Williamson
David R Mottram
Munir Pirmohamed
Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.
PLoS ONE
title Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.
title_full Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.
title_fullStr Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.
title_full_unstemmed Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.
title_short Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes.
title_sort adverse drug reactions in hospital in patients a prospective analysis of 3695 patient episodes
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0004439&type=printable
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