Prevalence of adverse drug reactions at a private tertiary care hospital in south India

BACKGROUND: Adverse Drug Reactions (ADRs) constitute an enormous burden for the society. The aim of the present study was to detect, document, assess and report the suspected ADRs and preparation of guidelines to minimize the incidence of ADRs. METHODS: A prospective-observational study was conducted in the Department of General Medicine of a tertiary care hospital for 12 months from April 2008 to March 2009. Detected and suspected ADRs were analyzed for causality, severity and preventability using appropriate validated scales and were reported. ADR alert card was prepared and given to patients. Therapeutic guidelines were prepared and given to the relevant departments. RESULTS: A total of 57 ADRs were detected, documented, assessed and reported during the study period the incidence was found to be 1.8%. Assessment of severity of the suspected ADRs revealed that 12% of suspected ADRs were severe and 49% of ADRs were moderate in severity. Causality assessment was done which revealed 63% of ADRs were possibly drug-related. The majority of patients who had suffered from ADRs were above 60 years (56%). Gastrointestinal system was most commonly affected (37%) and the drug class mostly associated with ADRs was antibiotics (23%). Preventability of ADRs was assessed; and the results revealed that 28% of ADRs were definitely preventable. CONCLUSIONS: Measures to improve detection and reporting of adverse drug reactions by all health care professionals is recommended to be undertaken, to ensure, and improve patient's safety. In this way, hospital/clinical pharmacists play the cornerstone role.

[1]  J. Jose,et al.  Pattern of adverse drug reactions notified by spontaneous reporting in an Indian tertiary care teaching hospital. , 2006, Pharmacological research.

[2]  D. Classen,et al.  Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. , 1997, JAMA.

[3]  D. Strachan,et al.  Increasing hospital admissions for systemic allergic disorders in England: analysis of national admissions data , 2003, BMJ : British Medical Journal.

[4]  B. M. Murphy,et al.  Development, implementation, and results of a successful multidisciplinary adverse drug reaction reporting program in a university teaching hospital. , 1993, Hospital pharmacy.

[5]  J. Shuster ISMP Adverse Drug Reactions. , 2013, Hospital pharmacy.

[6]  P. Schneider,et al.  Preventability and severity assessment in reporting adverse drug reactions. , 1992, American journal of hospital pharmacy.

[7]  R. Arulmani,et al.  Adverse drug reaction monitoring in a secondary care hospital in South India. , 2008, British journal of clinical pharmacology.

[8]  Jason Lazarou,et al.  Adverse Drug Reactions in Hospitalized Patients—Reply , 1998 .

[9]  ASHP guidelines on adverse drug reaction monitoring and reporting. American Society of Hospital Pharmacy. , 1995, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[10]  J. Jose,et al.  Implementation and results of an adverse drug reaction reporting programme at an Indian teaching hospital , 2006 .

[11]  D. Suh,et al.  Clinical and Economic Impact of Adverse Drug Reactions in Hospitalized Patients , 2000, The Annals of pharmacotherapy.

[12]  K. Stewart,et al.  Comment: Hospital Admissions Resulting from Preventable Adverse Drug Reactions , 2003, The Annals of pharmacotherapy.

[13]  P. Corey,et al.  Incidence of Adverse Drug Reactions in Hospitalized Patients , 2012 .

[14]  D. Greenblatt,et al.  A method for estimating the probability of adverse drug reactions , 1981, Clinical pharmacology and therapeutics.

[15]  M Pirmohamed,et al.  Adverse drug reactions in hospital in‐patients: a pilot study , 2006, Journal of clinical pharmacy and therapeutics.

[16]  L. Emmerton,et al.  An introduction to adverse drug reaction reporting systems in different countries , 2005 .

[17]  C. Raehl,et al.  Clinical Pharmacy Services, Pharmacy Staffing, and Adverse Drug Reactions in United States Hospitals , 2006, Pharmacotherapy.

[18]  D. Classen,et al.  Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. , 1997, JAMA.