Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Open Medicine

formerly Central European Journal of Medicine

Editor-in-Chief: Darzynkiewicz, Zbigniew

1 Issue per year


IMPACT FACTOR 2016 (Open Medicine): 0.294
IMPACT FACTOR 2016 (Central European Journal of Medicine): 0.116

CiteScore 2017: 0.53

SCImago Journal Rank (SJR) 2017: 0.154
Source Normalized Impact per Paper (SNIP) 2017: 0.264

Open Access
Online
ISSN
2391-5463
See all formats and pricing
More options …
Volume 5, Issue 3

Issues

Volume 10 (2015)

Spontaneous reporting of adverse drug reactions at a department of Internal Medicine

Zorica Jovic / Vidojko Djordjevic / Milovanovic Milena / Karin Vasic
Published Online: 2010-04-09 | DOI: https://doi.org/10.2478/s11536-009-0129-z

Abstract

The aim of the present study was to characterize the pattern of adverse drug reactions (ADRs) reported in a university teaching hospital in south-east Serbia. The study was conducted based on ADRs reported during a six-month period to the ADR reporting unit of the university clinical center. Evaluation of data was done for various parameters, such as patient demographics, drug and reaction characteristics, and outcome of reactions. Assessment was also done for causality, severity and predisposing factors. During the 6-month study period, 44 ADRs were reported, with an overall incidence of 0.33%. No significant difference was seen in the overall incidence of ADRs observed in males and females. Incidence of ADRs among elderly (43.2%) and older (25%) adults was significantly higher than in other age groups. Type A reactions (66.7%) accounted for majority of the reports. The most commonly affected organ system was the renal system, (22.7%) with hyperkalemia as the only reported reaction. ACE inhibitors (48.6%) were the drug class most commonly involved, where fosinopril (25.7%) was the individual drug most frequently reported. Additional treatment was pursued for management of ADRs in majority (52.3%) of the reports. In 52.3 % of the reports, the patient had recovered from the reaction by the time of evaluation. Upon causality assessment, the majority of the reports were rated as probable (43.2%). Mild and moderate reactions accounted for 43.2% and 54.6%, respectively. In 36.3% of the reports, the reaction was considered to be preventable. The most common predisposing factors were polypharmacy and multiple disease state. The pattern of ADRs reported in our hospital is comparable to the results of studies conducted in hospital set up elsewhere. Our evaluations revealed opportunities for intervention to ensure safer drug use.

Keywords: Adverse drug reactions; Spontaneous reporting; Hospitals

  • [1] Davies E.C., Green C.F., Mottram D.R., Pirmohamed M., Adverse drug reactions in hospital in-patients: a pilot study, Journal of Clinical Pharmacy and Therapeutics, 2006, 31, 335–341 http://dx.doi.org/10.1111/j.1365-2710.2006.00744.xCrossrefGoogle Scholar

  • [2] Somers A., Petrovic M., Robays H., Bogaert M., Reporting adverse drug reactions on a geriatric ward: a pilot project, Eur J Clin Pharmacol, 2003, 58, 707–714 Google Scholar

  • [3] Classen D.C., Pestotnik S.L., Evans R.S., Lloyd J.F., Burke J.P., Adverse drug events in hospitalized patients, Excess length of stay, extra costs, and attributable mortality, JAMA, 1997, 277, 301–306 http://dx.doi.org/10.1001/jama.277.4.301CrossrefGoogle Scholar

  • [4] Lagnaoui R., Moore N., Fach J., Longy-Boursier M., Begaud B., Adverse drug reactions in a department of systemic diseases-oriented internal medicine: prevalence, incidence, direct costs and avoidability, Eur J Clin Pharmacol, 2000, 56, 181–186 http://dx.doi.org/10.1007/s002280050738CrossrefGoogle Scholar

  • [5] Dormann H., Muth-Selbach U., Krebs B., Criegee-Rieck M., Tegeder I., Schneider H.T., et al., Incidence and costs of adverse drug reactions during hospital stay, Drug Saf, 2000, 22, 161–168 http://dx.doi.org/10.2165/00002018-200022020-00007CrossrefGoogle Scholar

  • [6] Moore N., Lecointre D., Nobelt C., Mabille M., Frequency and cost of serious adverse drug reactions in a department of general medicine, Br J Clin Pharmacol, 1998, 45, 301–308 http://dx.doi.org/10.1046/j.1365-2125.1998.00667.xCrossrefGoogle Scholar

  • [7] Levy M., Azaz-Livshits T., Sadan B., Shalit M., Geisslinger G., Brune K., Computerized surveillance of adverse drug reactions in hospital: implementation, Eur J Clin Pharmacol, 1999, 54, 887–892 http://dx.doi.org/10.1007/s002280050571CrossrefGoogle Scholar

  • [8] Ditto A.M., Drug allergy, In, Grammer L.C., Greenberger P.A., editors. Patterson’s allergic diseases. 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2002. p.295 Google Scholar

  • [9] Jick H., Adverse drug reactions: the magnitude of the problem, J Allergy Clin Immunol, 1984, 74, 555–557 http://dx.doi.org/10.1016/0091-6749(84)90106-4CrossrefGoogle Scholar

  • [10] Lazarou J., Pomeranz B.H., Corey P.N., Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies, JAMA, 1998, 279, 1200–1205 http://dx.doi.org/10.1001/jama.279.15.1200CrossrefGoogle Scholar

  • [11] Hartwig S.C., Siegel J., Schneider P.J., Preventability and severity assessment in reporting adverse drug reactions, Am J Hosp Pharm, 1992, 49, 2229–2232 Google Scholar

  • [12] American Society of Health System Pharmacists, ASHP guidelines on adverse drug reaction monitoring and reporting, Am J Hosp Pharm, 1989, 46, 336–337 Google Scholar

  • [13] Moride Y., Haramburu F., Requeyo A.A., Begaud B., Underreporting of adverse drug reactions in general practice, Br J Clin Pharmacol, 1997, 43(2), 177–181 http://dx.doi.org/10.1046/j.1365-2125.1997.05417.xCrossrefGoogle Scholar

  • [14] Alvarez-Requejo A., Carvajal A., Begaud B., Moride Y., Vega T., Martin Arias L.H., Underreporting of adverse drug reactions. Estimate based on a spontaneous reporting scheme and a sentinel system, Eur J Clin Pharmacol, 1998, 54, 483–488 http://dx.doi.org/10.1007/s002280050498CrossrefGoogle Scholar

  • [15] Gallelli L., Ferreri M., Colosimo M., Pirritano D., Flocco M.A., Pelaia G., et al., Retrospective analysis of adverse drug reactions to bronchodilators observed in two pulmonary divisions of Catanzaro, Italy, Pharmacol Res, 2003, 47(6), 493–499 http://dx.doi.org/10.1016/S1043-6618(03)00003-3CrossrefGoogle Scholar

  • [16] Rawlins M.D., Thompson J.W., Pathogenesis of adverse drug reactions, In: Davies DM, editor Textbook of adverse drug reactions. 1st ed.Oxford: Oxford University Press; 1977. p.44 Google Scholar

  • [17] WHO Collaborating Centre for Drug Statistics Methodology. Completed ATC Index 2005 Google Scholar

  • [18] Naranjo C.A., Busto U., Sellers E.M., Sandor P., Ruiz I., Roberts E.A., et al., A method for estimating the probability of adverse drug reactions, Clin Pharmacol Ther, 1981, 30, 239–245 CrossrefGoogle Scholar

  • [19] Lau P.M., Stewart K., Dooley M.J., Comment: hospital admissions resulting from preventable adverse drug reactions, Ann Pharmacother 2003, 37, 303–312 http://dx.doi.org/10.1345/aph.1A333aCrossrefGoogle Scholar

  • [20] Edwards I.R., Pharmacological basis of adverse drug reactions, In: Speight TM, Holford NHG, editors. Avery’s drug treatment. 4th ed. Auckland, New Zealand: Adis International; 1997. p. 261–299 Google Scholar

  • [21] Parthasarathi G., Olsson S., Adverse Drug Reactions, In: Parthasarathi G., Nyfort-Hansen K., Nahata M.C., editors. A textbook of clinical pharmacy practice-essential concepts and skills 1st ed. place: Orient Longmann; 2005. p. 85–102 Google Scholar

  • [22] Veehof L.J.G., Stewart R.E., Haaijer-Ruskamp F.M., Meyboom-de Jong B., The development of polypharmacy: A longitudinal study, Family Practice, 2000, 17(3), 261–267 http://dx.doi.org/10.1093/fampra/17.3.261CrossrefGoogle Scholar

  • [23] Bennett B.S., Lipman A.G., Comparative study of prospective surveillance and voluntary reporting in determining the incidence of adverse drug reactions, Am J Hosp Pharm, 1977, 34, 931–936 Google Scholar

  • [24] Impicciatore P., Choonara I., Clarkson A., Provasi D., Pandolfini C., Bonati M., Incidence of adverse drug reactions in pediatric in/out-patients: a systematic review and meta-analysis of prospective studies, Br J Clin Pharmacol, 2001, 52(1), 77–83 http://dx.doi.org/10.1046/j.0306-5251.2001.01407.xCrossrefGoogle Scholar

  • [25] Montastruc J.L., Lapeyre-Mestre M., Bagheri H., Fooladi A., Gender differences in adverse drug reactions: analysis of spontaneous reports to a Regional Pharmacovigilance Centre in France, Fundam Clin Pharmacol, 2002, 16(5), 343–346 http://dx.doi.org/10.1046/j.1472-8206.2002.00100.xCrossrefGoogle Scholar

  • [26] Bates D.W., Cullen D.J., Laird N., Petersen L.A., Small S.D., Servi D., et al., Incidence of adverse drug events and potential adverse drug eventsimplications for prevention, JAMA, 1995, 55(1), 29–34 http://dx.doi.org/10.1001/jama.274.1.29CrossrefGoogle Scholar

  • [27] Murphy B.M., Frigo LC., Development, implementation and results of a successful multidisciplinary adverse drug reaction reporting program in a university teaching hospital. Hosp Pharm, 1993, 28(12), 1199–1204 Google Scholar

  • [28] Suh D.C., Woodall B.S., Shin S.K., Hermes-De-Santis E.R., Clinical and economic impact of adverse drug reactions in hospitalized patients, Ann Pharmacother, 2000, 34, 1373–1379 CrossrefGoogle Scholar

  • [29] Prosser T.R., Kamysz P.L., Multidisciplinary adverse drug reaction surveillance program. Am J Hosp Pharm, 1990, 47(6), 1334–1339 Google Scholar

  • [30] Acker C.G., Johnson J.P., Palevsky P.M., Greenberg A., Hyperkalemia in hospitalized patients: causes, adequacy of treatment, and results of an attempt to improve physician compliance with published therapy guidelines, Arch Intern Med, 1998, 158, 917–924 http://dx.doi.org/10.1001/archinte.158.8.917CrossrefGoogle Scholar

  • [31] Rimmer J.M., Horn J.F., Gennari F.J., Hyperkalemia as a complication of drug therapy, Arch Intern Med, 1987, 147, 867–869 http://dx.doi.org/10.1001/archinte.147.5.867CrossrefGoogle Scholar

  • [32] Perazella M.A., Drug-induced hyperkalemia: old culprits and new offenders, Am J Med, 2000, 109, 307–314 http://dx.doi.org/10.1016/S0002-9343(00)00496-4CrossrefGoogle Scholar

  • [33] Ahuja T., Freeman D. Jr., Mahnken J.D., Agraharkar M., Siddiqui M., Memon A., Predictors of the development of hyperkalemia in patients using angiotensin-converting enzyme inhibitors, Am J Nephrol, 2000, 20, 268–272 http://dx.doi.org/10.1159/000013599CrossrefGoogle Scholar

  • [34] Reardon L.C., Macpherson D.S., Hyperkalemia in outpatients using angiotensin-converting enzyme inhibitors, Arch Intern Med, 1998, 158, 26–32 http://dx.doi.org/10.1001/archinte.158.1.26CrossrefGoogle Scholar

  • [35] Gholami K., Shalviri G., Factors associated with preventability, predictability and severity of adverse drug reactions, Ann Pharmacother, 1999, 33(2), 236–240 http://dx.doi.org/10.1345/aph.17440CrossrefGoogle Scholar

  • [36] Gonzalez-Martin G., Caroca C.M., Paris E., Adverse drug reactions /ADRs/ in hospitalized pediatric patients-a prospective study, Int J Clin Pharmacol Ther, 1998, 36(10), 530–533 Google Scholar

  • [37] Jose J., Rao P.G.M., Pattern of adverse drug reactions notified by spontaneous reporting in an Indian tertiary care teaching hospital, Pharmacological Research, 2006, 54(3), 226–233 http://dx.doi.org/10.1016/j.phrs.2006.05.003CrossrefGoogle Scholar

  • [38] Kanjanarat P., Winterstein A.G., Johns T.E., Hatton R.C., Gonzalez-Rothi R., Segal R., Nature of preventable adverse drug events in hospitals: a literature review, Am J Health Syst Pharm, 2003, 60, 1750–1759 Google Scholar

  • [39] Bates D.W., Leape L.L., Petrycki S., Incidence and preventability of adverse drug events in hospitalized adults, J Gen Intern Med, 1993, 8, 289–294 http://dx.doi.org/10.1007/BF02600138CrossrefGoogle Scholar

  • [40] Gandhi T.K., Weingart S.N., Borus J., Seger A.C., Peterson J., Burdick E., et al., Adverse drug events in ambulatory care, N Eng J Med, 2003, 348, 1156–1164 http://dx.doi.org/10.1056/NEJMsa020703CrossrefGoogle Scholar

  • [41] Evans R.S., Lloyd J.F., Stoddard G.J., Neberker J.R., Samore M.H., Risk factors for adverse drug events: a 10 year analysis, Ann Pharmacother, 2005, 39, 1161–1168 http://dx.doi.org/10.1345/aph.1E642CrossrefGoogle Scholar

  • [42] Fonescue E.B., Kausbal R., Landrigan C.P., McKenna K.J., Clapp M.D., Federico F., et al., Prioritizing strategies for preventing medication errors and adverse drug events in pediatric inpatients, Pediatrics, 2003, 111(4 Pt 1), 722–729 Google Scholar

  • [43] Field T.S., Gurwitz J.H., Avorn J., McCormick D., Jain S., Eckier M., et al., Risk factors for adverse drug events among nursing home residents, Arch Intern Med, 2001, 161, 1629–1634 http://dx.doi.org/10.1001/archinte.161.13.1629CrossrefGoogle Scholar

  • [44] Bates D.W., Miller E.B., Cullen, Burdick L., Williams L., Laird N., et al., Patient risk factors for adverse drug events in hospitalized patients, Arch Intern Med, 1999, 159, 2553–2559 http://dx.doi.org/10.1001/archinte.159.21.2553CrossrefGoogle Scholar

About the article

Published Online: 2010-04-09

Published in Print: 2010-06-01


Citation Information: Open Medicine, Volume 5, Issue 3, Pages 338–346, ISSN (Online) 2391-5463, DOI: https://doi.org/10.2478/s11536-009-0129-z.

Export Citation

© 2010 Versita Warsaw. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. BY-NC-ND 3.0

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Sylvie D. Price, C. D'Arcy J. Holman, Frank M. Sanfilippo, and Jon D. Emery
Pharmacoepidemiology and Drug Safety, 2013, Volume 22, Number 11, Page 1159

Comments (0)

Please log in or register to comment.
Log in