Adverse Drug Event (ADE) related Medical Emergency Department visits and hospital admissions: a prospective study from a North Indian Referral Hospital
Dr Lekha Saha, Senior lecturer, Dept of Pharmacology, Govt Medical College, Chandigarh.India. Ph â€“91-0172-2645262. Emailfirstname.lastname@example.org
Objective: To analyse the contribution of adverse drug events to the overall number of visits, to the emergency medical outpatient department(EMOPD) of a tertiary care centre. The aim of the present study was also to characterise the different causes of drug related visits or admissions and the consequences of it on the cost of health care.
Patients and methods: All visits to the medical emergency were recorded in a prospective, non-interventional design study, over a period of 6 months. In order to maximize uniformity and minimize interpersonal variability and bias, the correlation of suspected drug(s) causing the problem that led to the EMOPD visit and hospital admission, was assessed by using the Naranjo probability scale. The cases of suspected ADEs were followed-up to find out whether they were discharged from the EMOPD itself, or whether they subsequently required hospitalisation.
Results: A total of 1200 patients were included in the study .Fifty patients (4.2%, 95% CI: 1.21 â€“ 6.53) were considered to be related to adverse drug events. Half of all the adverse effects could be attributed to three drugs: NSAIDS associated GI bleeding (22%), antitubercular drug associated hepatitis (20%),and beta-lactam associated hypersensitivity reactions (8%). In the present study, we found that 10% of ADEs were life threatening, and 30% were serious to warrant hospitalisation .The hospital admissions that were related to adverse drug events accounted for US$6712 or US $134 per admission.
Conclusion: ADEs account for a sizable proportion of all visits to a medical emergency unit, and some are serious enough to require hospitalisation .A large number of ADE related visits and admissions are preventable, which highlights the importance of public education on the proper use of drugs, and also, the need for regulation of the practice of unregistered medical practitioners in developing countries.