Skip to main content
Top
Published in: Drug Safety 2/2006

01-02-2006 | Original Research Article

Adverse Drug Reaction-Related Hospitalisations

A Nationwide Study in The Netherlands

Authors: Cornelis S. van der Hooft, Miriam C.J.M. Sturkenboom, Kees van Grootheest, Herre J. Kingma, Dr Bruno H.Ch. Stricker

Published in: Drug Safety | Issue 2/2006

Login to get access

Abstract

Background: The incidence of adverse drug reaction (ADR)-related hospitalisations has usually been assessed within hospitals. Because of the variability in results and methodology, it is difficult to extrapolate these results to a national level.
Objectives: To evaluate the incidence and characteristics of ADR-related hospitalisations in The Netherlands in 2001.
Methods: We conducted a nationwide study of all hospital admissions in 2001. Data were retrieved from a nationwide computer database for hospital discharge records. All acute, non-planned admissions to all Dutch academic and general hospitals in 2001 were included in the study (n = 668 714). From these admissions we selected all hospitalisations that were coded as drug-related, but intended forms of overdose, errors in administration and therapeutic failures were excluded. Hence, we extracted all ADR-related hospitalisations. We compared age, sex and the risk of a fatal outcome between patients admitted with ADRs and patients admitted for other reasons, as well as the most frequent main diagnoses in ADR-related hospitalisations and which drugs most frequently caused the ADRs. In addition, we evaluated to what extent these ADRs were reported to the Netherlands Pharmacovigilance Centre Lareb for spontaneous ADR reporting.
Results: In 2001, 12 249 hospitalisations were coded as ADR related. This was 1.83% of all acute hospital admissions in The Netherlands (95% CI 1.80, 1.86). The proportion increased with age from 0.8% (95% CI 0.75, 0.85) in the <18 years group to 3.2% in the ≥80 years group (95% CI 3.08, 3.32). The most frequent ADR-related diagnoses of hospitalisations were bleeding (n = 1048), non-specified ‘unintended effect of drug’ (n = 438), hypoglycaemia (n = 375) and fever (n = 347). The drugs most commonly associated with ADR-related hospitalisations were anticoagulants (n = 2185), cytostatics and immunosuppressives (n = 1809) and diuretics (n = 979). Six percent of the ADR-related hospitalisations had a fatal outcome (n = 734). Older age and female gender were associated with ADR-related hospitalisations. Only approximately 1% of the coded ADRs causing hospitalisation were reported to our national centre for spontaneous ADR reporting.
Conclusion: The proportion of ADR-related hospitalisations is substantial, especially considering the fact that not all ADRs may be recognised or mentioned in discharge letters. Under-reporting of ADRs that result in hospital admission to our national centre for spontaneous ADR reporting was considerable.
Literature
1.
go back to reference Roughead EE, Gilbert AL, Primrose JG, et al. Drug-related hospital admissions: a review of Australian studies published 1988-1996. Med J Aust 1998; 168(8): 405–8PubMed Roughead EE, Gilbert AL, Primrose JG, et al. Drug-related hospital admissions: a review of Australian studies published 1988-1996. Med J Aust 1998; 168(8): 405–8PubMed
2.
go back to reference Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 1998; 279(15): 1200–5PubMedCrossRef Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 1998; 279(15): 1200–5PubMedCrossRef
3.
go back to reference Muehlberger N, Schneeweiss S, Hasford J. Adverse drug reaction monitoring-cost and benefit considerations. Part I: frequency of adverse drug reactions causing hospital admissions. Pharmacoepidemiol Drug Saf 1997; 6(S3): S71–7PubMedCrossRef Muehlberger N, Schneeweiss S, Hasford J. Adverse drug reaction monitoring-cost and benefit considerations. Part I: frequency of adverse drug reactions causing hospital admissions. Pharmacoepidemiol Drug Saf 1997; 6(S3): S71–7PubMedCrossRef
4.
go back to reference Beijer HJ, de Blaey CJ. Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies. Pharm World Sci 2002; 24(2): 46–54PubMedCrossRef Beijer HJ, de Blaey CJ. Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies. Pharm World Sci 2002; 24(2): 46–54PubMedCrossRef
5.
go back to reference Pirmohamed M, James S, Meakin S, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004; 329(7456): 15–9PubMedCrossRef Pirmohamed M, James S, Meakin S, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004; 329(7456): 15–9PubMedCrossRef
6.
go back to reference Onder G, Pedone C, Landi F, et al. Adverse drug reactions as cause of hospital admissions: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). J Am Geriatr Soc 2002; 50(12): 1962–8PubMedCrossRef Onder G, Pedone C, Landi F, et al. Adverse drug reactions as cause of hospital admissions: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). J Am Geriatr Soc 2002; 50(12): 1962–8PubMedCrossRef
7.
go back to reference Routledge PA, O’Mahony MS, Woodhouse KW. Adverse drug reactions in elderly patients. Br J Clin Pharmacol 2004; 57(2): 121–6PubMedCrossRef Routledge PA, O’Mahony MS, Woodhouse KW. Adverse drug reactions in elderly patients. Br J Clin Pharmacol 2004; 57(2): 121–6PubMedCrossRef
8.
go back to reference Pouyanne P, Haramburu F, Imbs JL, et al. Admissions to hospital caused by adverse drug reactions: cross sectional incidence study. French Pharmacovigilance Centres. BMJ 2000; 320(7241): 1036PubMedCrossRef Pouyanne P, Haramburu F, Imbs JL, et al. Admissions to hospital caused by adverse drug reactions: cross sectional incidence study. French Pharmacovigilance Centres. BMJ 2000; 320(7241): 1036PubMedCrossRef
9.
go back to reference International Classification of Diseases. 9th Rev. Clinical modification (ICD-9-CM). Michigan: Commission on Professional and Hospital activities, 1978 International Classification of Diseases. 9th Rev. Clinical modification (ICD-9-CM). Michigan: Commission on Professional and Hospital activities, 1978
10.
go back to reference van Grootheest AC. Improving pharmacovigilance and the role of the pharmacist. [PhD dissertation]. Groningen: University of Groningen, 2003 van Grootheest AC. Improving pharmacovigilance and the role of the pharmacist. [PhD dissertation]. Groningen: University of Groningen, 2003
11.
go back to reference Alvarez-Requejo A, Carvajal A, Begaud B, et al. Under-reporting of adverse drug reactions: estimate based on a spontaneous reporting scheme and a sentinel system. Eur J Clin Pharmacol 1998; 54(6): 483–8PubMedCrossRef Alvarez-Requejo A, Carvajal A, Begaud B, et al. Under-reporting of adverse drug reactions: estimate based on a spontaneous reporting scheme and a sentinel system. Eur J Clin Pharmacol 1998; 54(6): 483–8PubMedCrossRef
12.
go back to reference Eland IA, Belton KJ, van Grootheest AC, et al. Attitudinal survey of voluntary reporting of adverse drug reactions. Br J Clin Pharmacol 1999; 48(4): 623–7PubMedCrossRef Eland IA, Belton KJ, van Grootheest AC, et al. Attitudinal survey of voluntary reporting of adverse drug reactions. Br J Clin Pharmacol 1999; 48(4): 623–7PubMedCrossRef
13.
go back to reference Nelson KM, Talbert RL. Drug-related hospital admissions. Pharmacotherapy 1996; 16(4): 701–7PubMed Nelson KM, Talbert RL. Drug-related hospital admissions. Pharmacotherapy 1996; 16(4): 701–7PubMed
14.
go back to reference Mannesse CK, Derkx FH, de Ridder MA, et al. Contribution of adverse drug reactions to hospital admission of older patients. Age Ageing 2000; 29(1): 35–9PubMedCrossRef Mannesse CK, Derkx FH, de Ridder MA, et al. Contribution of adverse drug reactions to hospital admission of older patients. Age Ageing 2000; 29(1): 35–9PubMedCrossRef
15.
go back to reference Mjorndal T, Boman MD, Hagg S, et al. Adverse drug reactions as a cause for admissions to a department of internal medicine. Pharmacoepidemiol Drug Saf 2002; 11(1): 65–72PubMedCrossRef Mjorndal T, Boman MD, Hagg S, et al. Adverse drug reactions as a cause for admissions to a department of internal medicine. Pharmacoepidemiol Drug Saf 2002; 11(1): 65–72PubMedCrossRef
16.
go back to reference Hallas J, Haghfelt T, Gram LF, et al. Drug related admissions to a cardiology department; frequency and avoidability. J Intern Med 1990; 228(4): 379–84PubMedCrossRef Hallas J, Haghfelt T, Gram LF, et al. Drug related admissions to a cardiology department; frequency and avoidability. J Intern Med 1990; 228(4): 379–84PubMedCrossRef
17.
go back to reference Williamson J, Chopin JM. Adverse reactions to prescribed drugs in the elderly: a multicentre investigation. Age Ageing 1980; 9(2): 73–80PubMedCrossRef Williamson J, Chopin JM. Adverse reactions to prescribed drugs in the elderly: a multicentre investigation. Age Ageing 1980; 9(2): 73–80PubMedCrossRef
18.
go back to reference Davidsen F, Haghfelt T, Gram LF, et al. Adverse drug reactions and drug non-compliance as primary causes of admission to a cardiology department. Eur J Clin Pharmacol 1988; 34(1): 83–6PubMedCrossRef Davidsen F, Haghfelt T, Gram LF, et al. Adverse drug reactions and drug non-compliance as primary causes of admission to a cardiology department. Eur J Clin Pharmacol 1988; 34(1): 83–6PubMedCrossRef
19.
go back to reference Carbonin P, Pahor M, Bernabei R, et al. Is age an independent risk factor of adverse drug reactions in hospitalized medical patients? J Am Geriatr Soc 1991; 39(11): 1093–9PubMed Carbonin P, Pahor M, Bernabei R, et al. Is age an independent risk factor of adverse drug reactions in hospitalized medical patients? J Am Geriatr Soc 1991; 39(11): 1093–9PubMed
20.
go back to reference Lassila HC, Stoehr GP, Ganguli M, et al. Use of prescription medications in an elderly rural population: the MoVIES Project. Ann Pharmacother 1996; 30(6): 589–95PubMed Lassila HC, Stoehr GP, Ganguli M, et al. Use of prescription medications in an elderly rural population: the MoVIES Project. Ann Pharmacother 1996; 30(6): 589–95PubMed
21.
go back to reference Straand J, Rokstad KS. Elderly patients in general practice: diagnoses, drugs and inappropriate prescriptions. A report from the More & Romsdal Prescription Study. Fam Pract 1999; 16(4): 380–8PubMedCrossRef Straand J, Rokstad KS. Elderly patients in general practice: diagnoses, drugs and inappropriate prescriptions. A report from the More & Romsdal Prescription Study. Fam Pract 1999; 16(4): 380–8PubMedCrossRef
22.
go back to reference Roughead EE, Gilbert AL, Primrose JG, et al. Coding drug-related hospital admissions in the medical record: is it adequate for monitoring the quality of medication use? Aust J Hosp Pharm 1998; 28: 7–12 Roughead EE, Gilbert AL, Primrose JG, et al. Coding drug-related hospital admissions in the medical record: is it adequate for monitoring the quality of medication use? Aust J Hosp Pharm 1998; 28: 7–12
Metadata
Title
Adverse Drug Reaction-Related Hospitalisations
A Nationwide Study in The Netherlands
Authors
Cornelis S. van der Hooft
Miriam C.J.M. Sturkenboom
Kees van Grootheest
Herre J. Kingma
Dr Bruno H.Ch. Stricker
Publication date
01-02-2006
Publisher
Springer International Publishing
Published in
Drug Safety / Issue 2/2006
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.2165/00002018-200629020-00006

Other articles of this Issue 2/2006

Drug Safety 2/2006 Go to the issue