Skip to main content
Top
Published in: Drug Safety 10/2001

01-08-2001 | Original Research Article

Postdischarge Adverse Drug Reactions in Primary Care Originating from Hospital Care in France

A Nationwide Prospective Study

Authors: Laurent Letrilliart, Thomas Hanslik, Michel Biour, Jean-Paul Fagot, Marguerite Guiguet, Dr Antoine Flahault

Published in: Drug Safety | Issue 10/2001

Login to get access

Abstract

Objective: To describe and estimate the incidence and preventability of postdischarge adverse drug reactions (ADRs) detected in primary care in France.
Design: Prospective study of patients referred to hospital by participating general practitioners (GPs). These GPs reported all cases of an adverse reaction to a drug instituted in hospital among patients who consulted them within 30 days of discharge.
Setting: 305 general practices from all French regions.
Patients: 7540 patients referred by GPs to private or public hospitals.
Main outcome measures: The incidence for postdischarge ADRs in primary care, and their preventability.
Results: 30 cases of postdischarge ADR were detected in 29 re-consulting patients, yielding a minimal incidence for France of 0.4 per 100 admissions (95% confidence interval 0.3 to 0.6). The ADRs were assessed as serious in 60% of cases. The main drug classes implicated were cardiovascular drugs (8 ADRs), oral anticoagulants (6), psychoactive drugs (4), antidiabetics (3), and opioid analgesics (3). Patients experiencing a postdischarge ADR were older than patients not experiencing one (median age: 77 vs 68 years; p = 0.004). Detected ADRs were considered preventable in 59% of cases.
Conclusions: Physicians and patients should be aware of the possible occurrence of postdischarge ADRs. Patient information in hospital, close postdischarge follow-up of patients at risk, and appropriate transmission of information between hospital physicians and GPs can help to prevent them.
Literature
1.
go back to reference Larazou J, Pomeranz B, Corey P. Incidence of adverse drug reactions in hospitalized patients. JAMA 1998; 279: 1200–5CrossRef Larazou J, Pomeranz B, Corey P. Incidence of adverse drug reactions in hospitalized patients. JAMA 1998; 279: 1200–5CrossRef
2.
go back to reference Imbs J, Pouyanne P, Haramburu F, et al. Iatrogenie médicamenteuse: estimation de sa prévalence dans les hôpitaux publics français. Thérapie 1999; 54: 21–7PubMed Imbs J, Pouyanne P, Haramburu F, et al. Iatrogenie médicamenteuse: estimation de sa prévalence dans les hôpitaux publics français. Thérapie 1999; 54: 21–7PubMed
3.
go back to reference Ministère de l’Emploi et de la Solidarité. Annuaire des Statistiques Sanitaires et Sociales. 1998 ed. Paris: SESI, 1999 Ministère de l’Emploi et de la Solidarité. Annuaire des Statistiques Sanitaires et Sociales. 1998 ed. Paris: SESI, 1999
4.
go back to reference Pokras R, Kozak L, McCarthy E, et al. Trends in Hospital Utilization, 1965-86. Am J Public Health 1990; 80: 488–90PubMedCrossRef Pokras R, Kozak L, McCarthy E, et al. Trends in Hospital Utilization, 1965-86. Am J Public Health 1990; 80: 488–90PubMedCrossRef
5.
go back to reference Klein U, Klein M, Sturm H, et al. The frequency of adverse drug reactions as dependent upon age, sex, and duration of hospitalization. Int J Clin Pharmacol 1976; 13: 187–95 Klein U, Klein M, Sturm H, et al. The frequency of adverse drug reactions as dependent upon age, sex, and duration of hospitalization. Int J Clin Pharmacol 1976; 13: 187–95
6.
go back to reference Weigelt J, Dryer D, Haley R. The necessity and efficiency of wound surveillance after discharge. Arch Surg 1992; 127: 77–82PubMedCrossRef Weigelt J, Dryer D, Haley R. The necessity and efficiency of wound surveillance after discharge. Arch Surg 1992; 127: 77–82PubMedCrossRef
7.
go back to reference Iezzoni L, Mackiernan Y, Chalane M, et al. Screening inpatient quality using post-discharge events. Med Care 1999; 37: 384–98PubMedCrossRef Iezzoni L, Mackiernan Y, Chalane M, et al. Screening inpatient quality using post-discharge events. Med Care 1999; 37: 384–98PubMedCrossRef
8.
go back to reference Valleron A, Garnerin P. Computer networking as a tool for public health surveillance: the French experiment. MMWR Morb Mortal Wkly Rep 1992; 41: 101–10PubMed Valleron A, Garnerin P. Computer networking as a tool for public health surveillance: the French experiment. MMWR Morb Mortal Wkly Rep 1992; 41: 101–10PubMed
12.
go back to reference Keissler D. Introducing MEDWatch: a new approach to reporting medication and device adverse effects and product problems. JAMA 1993; 269: 2765–8CrossRef Keissler D. Introducing MEDWatch: a new approach to reporting medication and device adverse effects and product problems. JAMA 1993; 269: 2765–8CrossRef
13.
go back to reference Benichou C. Imputability of unexpected or toxic drug reactions. In: Benichou C, Bouche P, Caron J, et al., editors. Adverse drug reactions. A practical guide to diagnosis and management. New York (NY): J Wiley & Sons, 1994: 271–5 Benichou C. Imputability of unexpected or toxic drug reactions. In: Benichou C, Bouche P, Caron J, et al., editors. Adverse drug reactions. A practical guide to diagnosis and management. New York (NY): J Wiley & Sons, 1994: 271–5
14.
go back to reference Imbs JL, Pletan Y, Spriet A. Evaluation de la iatrogènese médicamenteuse évitable: méthodologie. Thérapie 1998; 53: 365–70PubMed Imbs JL, Pletan Y, Spriet A. Evaluation de la iatrogènese médicamenteuse évitable: méthodologie. Thérapie 1998; 53: 365–70PubMed
16.
go back to reference Vidal dictionary. 76th ed. Paris: Editions du Vidal, 2000 Vidal dictionary. 76th ed. Paris: Editions du Vidal, 2000
17.
go back to reference Gardner M, Altman D. Statistics with confidence: confidence intervals and statistical guidelines. London: BMJ Books, 1989: 116–8 Gardner M, Altman D. Statistics with confidence: confidence intervals and statistical guidelines. London: BMJ Books, 1989: 116–8
18.
go back to reference Spino M, Sellers E, Kaplan H, et al. Adverse biochemical and clinical consequences of furosemide administration. Can Med Assoc J 1978; 118: 1513–8PubMed Spino M, Sellers E, Kaplan H, et al. Adverse biochemical and clinical consequences of furosemide administration. Can Med Assoc J 1978; 118: 1513–8PubMed
19.
go back to reference Pillans P, Coulter D, Black P. Angiooedema and urticaria with angiotensin converting inhibitors. Eur J Clin Pharmacol 1996; 51: 123–6PubMedCrossRef Pillans P, Coulter D, Black P. Angiooedema and urticaria with angiotensin converting inhibitors. Eur J Clin Pharmacol 1996; 51: 123–6PubMedCrossRef
20.
go back to reference Skjelbred P. The effects of acetylsalicylic acid on swelling, pain and other events after surgery. Br J Clin Pharmacol 1984; 17: 379–84PubMedCrossRef Skjelbred P. The effects of acetylsalicylic acid on swelling, pain and other events after surgery. Br J Clin Pharmacol 1984; 17: 379–84PubMedCrossRef
21.
go back to reference van Kraaij DJ, Jansen R, Bouwels L, et al. Furosemide withdrawal in elderly heart failure patients with preserved left ventricular systolic function. Am J Cardiol 2000; 85: 1461–6PubMedCrossRef van Kraaij DJ, Jansen R, Bouwels L, et al. Furosemide withdrawal in elderly heart failure patients with preserved left ventricular systolic function. Am J Cardiol 2000; 85: 1461–6PubMedCrossRef
22.
go back to reference Dukes M. Meyler’s side effects of drugs. 13th ed. Amsterdam: Elsevier Science Publishers, 1996 Dukes M. Meyler’s side effects of drugs. 13th ed. Amsterdam: Elsevier Science Publishers, 1996
23.
go back to reference McAreavey D, Robertson J. Angiotensin converting enzyme inhibitors and moderate hypertension. Drugs 1990; 40: 326–45PubMedCrossRef McAreavey D, Robertson J. Angiotensin converting enzyme inhibitors and moderate hypertension. Drugs 1990; 40: 326–45PubMedCrossRef
24.
go back to reference The European atrial fibrillation trial study group. Optimal oral anticoagulant therapy in patients with nonrheumatic atrial fibrillation and recent cerebral ischemia. N Engl J Med 1995; 333: 5–10 The European atrial fibrillation trial study group. Optimal oral anticoagulant therapy in patients with nonrheumatic atrial fibrillation and recent cerebral ischemia. N Engl J Med 1995; 333: 5–10
25.
go back to reference Fava M, Rosenbaum J, Hoog S, et al. Fluoxetine versus sertraline and paroxetine in major depression: tolerability and efficacy in anxious depression. J Affect Disord 2000; 59: 119–26PubMedCrossRef Fava M, Rosenbaum J, Hoog S, et al. Fluoxetine versus sertraline and paroxetine in major depression: tolerability and efficacy in anxious depression. J Affect Disord 2000; 59: 119–26PubMedCrossRef
26.
go back to reference Bocksberger J, Gex-Fabry M, Gauthey L, et al. Clomipramine therapy in the geriatric drug monitoring. Ther Drug Monit 1994; 16: 113–9PubMedCrossRef Bocksberger J, Gex-Fabry M, Gauthey L, et al. Clomipramine therapy in the geriatric drug monitoring. Ther Drug Monit 1994; 16: 113–9PubMedCrossRef
27.
go back to reference Egbert A, Parks L, Short L, et al. Randomized trial of postoperative patient-controlled analgesia vs intramuscular narcotics in frail elderly men. Arch Intern Med 1990; 150: 1897–903PubMedCrossRef Egbert A, Parks L, Short L, et al. Randomized trial of postoperative patient-controlled analgesia vs intramuscular narcotics in frail elderly men. Arch Intern Med 1990; 150: 1897–903PubMedCrossRef
28.
go back to reference United Kingdom Prospective Diabetes Study Group. United Kingdom prospective diabetes study (UKPDS) 13: relative efficacy of randomly allocated diet, sulphonylurea, insulin, or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. BMJ 1995; 310: 83–8 United Kingdom Prospective Diabetes Study Group. United Kingdom prospective diabetes study (UKPDS) 13: relative efficacy of randomly allocated diet, sulphonylurea, insulin, or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. BMJ 1995; 310: 83–8
29.
go back to reference Ytterberg S, Mahowald M, Woods S. Codeine and oxycodone use in patients with chronic rheumatic disease pain. Arthritis Rheum 1998; 41: 1603–2PubMedCrossRef Ytterberg S, Mahowald M, Woods S. Codeine and oxycodone use in patients with chronic rheumatic disease pain. Arthritis Rheum 1998; 41: 1603–2PubMedCrossRef
30.
go back to reference Kjaersgaard-Andersen P, Nafei A, Skov O, et al. Codeine plus paracetamol versus paracetamol in longer-term treatment of chronic pain due to osteoarthritis of the hip: a randomised, double-blind, multi-centre study. Pain 1990; 43: 309–18PubMedCrossRef Kjaersgaard-Andersen P, Nafei A, Skov O, et al. Codeine plus paracetamol versus paracetamol in longer-term treatment of chronic pain due to osteoarthritis of the hip: a randomised, double-blind, multi-centre study. Pain 1990; 43: 309–18PubMedCrossRef
31.
go back to reference Wilton L, Pearce G, Mann R. A comparison of ciprofloxacin, norfloxacine, ofloxacine, azithromycin and cefixime examined by observational cohort studies. Br J Clin Pharmacol 1996; 41: 277–84PubMedCrossRef Wilton L, Pearce G, Mann R. A comparison of ciprofloxacin, norfloxacine, ofloxacine, azithromycin and cefixime examined by observational cohort studies. Br J Clin Pharmacol 1996; 41: 277–84PubMedCrossRef
32.
go back to reference Royer R. Adverse drug reactions with fluoroquinolones. Therapie 1996; 51: 414–6PubMed Royer R. Adverse drug reactions with fluoroquinolones. Therapie 1996; 51: 414–6PubMed
33.
go back to reference Frykman E, Bystrom M, Jansson U, et al. Side effects of iron supplements in blood donors: Superior tolerance of heme iron. J Lab Clin Med 1994; 123: 561–4PubMed Frykman E, Bystrom M, Jansson U, et al. Side effects of iron supplements in blood donors: Superior tolerance of heme iron. J Lab Clin Med 1994; 123: 561–4PubMed
34.
go back to reference Perry M, Eaton W, Propert K, et al. Chemotherapy with or without radiation therapy in limited small-cell carcinoma of the lung. N Engl J Med 1987; 316: 912–8PubMedCrossRef Perry M, Eaton W, Propert K, et al. Chemotherapy with or without radiation therapy in limited small-cell carcinoma of the lung. N Engl J Med 1987; 316: 912–8PubMedCrossRef
35.
go back to reference Crawford J, Ozer H, Stoller R, et al. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. N Engl J Med 1991; 325: 164–70PubMedCrossRef Crawford J, Ozer H, Stoller R, et al. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. N Engl J Med 1991; 325: 164–70PubMedCrossRef
36.
go back to reference Miremont G, Haramburu F, Begaud B, et al. Adverse drug reactions: physicians’ opinions versus a causality assessment method. Eur J Clin Pharmacol 1994; 46: 285–9PubMedCrossRef Miremont G, Haramburu F, Begaud B, et al. Adverse drug reactions: physicians’ opinions versus a causality assessment method. Eur J Clin Pharmacol 1994; 46: 285–9PubMedCrossRef
37.
go back to reference Kellaway GS. Intensive monitoring for adverse drug effects in patients discharged from acute medical wards. NZ Med J 1973; 78: 525–8 Kellaway GS. Intensive monitoring for adverse drug effects in patients discharged from acute medical wards. NZ Med J 1973; 78: 525–8
38.
go back to reference Moride Y, Haramburu F, Requejo A, et al. Under-reporting of adverse drug reactions in general practice. Br J Clin Pharmacol 1997; 43: 177–81PubMedCrossRef Moride Y, Haramburu F, Requejo A, et al. Under-reporting of adverse drug reactions in general practice. Br J Clin Pharmacol 1997; 43: 177–81PubMedCrossRef
39.
go back to reference Frankl S, Breeling J, Goldman L. Preventability of emergent hospital readmission. Am J Med 1991; 90: 667–74PubMed Frankl S, Breeling J, Goldman L. Preventability of emergent hospital readmission. Am J Med 1991; 90: 667–74PubMed
40.
go back to reference Hewitt J. Drug-related unplanned readmissions to hospital. Aust J Hosp Pharm 1995; 25: 400–3 Hewitt J. Drug-related unplanned readmissions to hospital. Aust J Hosp Pharm 1995; 25: 400–3
41.
go back to reference Mouquet M, Joubert M, Tudeau L. Les pathologies prises en charge à l’hôpital. Direction de la Recherche, des Etudes et de l’Evaluation et des Statistiques, Ministère de l’Emploi et de la Solidarité. Etudes et résultats 1999; 41: 1–8 Mouquet M, Joubert M, Tudeau L. Les pathologies prises en charge à l’hôpital. Direction de la Recherche, des Etudes et de l’Evaluation et des Statistiques, Ministère de l’Emploi et de la Solidarité. Etudes et résultats 1999; 41: 1–8
42.
go back to reference Moore N, Lecointre D, Noblet C, et al. Frequency and cost of serious adverse drug reactions in a department of general medicine. Br J Clin Pharmacol 1998; 45: 301–8PubMedCrossRef Moore N, Lecointre D, Noblet C, et al. Frequency and cost of serious adverse drug reactions in a department of general medicine. Br J Clin Pharmacol 1998; 45: 301–8PubMedCrossRef
43.
44.
go back to reference Gurwitz J, Avorn J. The ambiguous relation between aging and adverse drug reactions. Ann Intern Med 1991; 114: 956–66PubMed Gurwitz J, Avorn J. The ambiguous relation between aging and adverse drug reactions. Ann Intern Med 1991; 114: 956–66PubMed
45.
go back to reference Leape L, Brennan T, Laird N, et al. The nature of adverse events in hospitalized patients: results of the Harvard Medical Practice Study II. N Engl J Med 1991; 324: 377–84PubMedCrossRef Leape L, Brennan T, Laird N, et al. The nature of adverse events in hospitalized patients: results of the Harvard Medical Practice Study II. N Engl J Med 1991; 324: 377–84PubMedCrossRef
46.
go back to reference Bates D, Miller E, Cullen D, et al. Patient risk factors for adverse drug events in hospitalized patients. Arch Intern Med 1999; 159: 2553–60PubMedCrossRef Bates D, Miller E, Cullen D, et al. Patient risk factors for adverse drug events in hospitalized patients. Arch Intern Med 1999; 159: 2553–60PubMedCrossRef
47.
go back to reference Beers M, Dang J, Hasegawa J, et al. Influence of hospitalization on drug therapy in the elderly. J Am Geriatr Soc 1989; 37: 679–83PubMed Beers M, Dang J, Hasegawa J, et al. Influence of hospitalization on drug therapy in the elderly. J Am Geriatr Soc 1989; 37: 679–83PubMed
48.
go back to reference Omori D, Potyk R, Kroenke K. The adverse effects of hospitalization on drug regimens. Arch Intern Med 1991; 151: 1562–4PubMedCrossRef Omori D, Potyk R, Kroenke K. The adverse effects of hospitalization on drug regimens. Arch Intern Med 1991; 151: 1562–4PubMedCrossRef
49.
go back to reference Seeger J, Kong S, Schumock G. Characteristics associated with ability to prevent adverse drug reactions in hospitalized patients. Pharmacotherapy 1998; 18: 1284–9PubMed Seeger J, Kong S, Schumock G. Characteristics associated with ability to prevent adverse drug reactions in hospitalized patients. Pharmacotherapy 1998; 18: 1284–9PubMed
50.
go back to reference Bates D, Leape L, Petrycki S. Incidence and preventability of adverse drug events in hospitalized adults. J Gen Intern Med 1991; 8: 289–94CrossRef Bates D, Leape L, Petrycki S. Incidence and preventability of adverse drug events in hospitalized adults. J Gen Intern Med 1991; 8: 289–94CrossRef
51.
go back to reference Bates D, Cullen D, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. JAMA 1995; 274: 29–34PubMedCrossRef Bates D, Cullen D, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. JAMA 1995; 274: 29–34PubMedCrossRef
52.
go back to reference Pearson T, Pittman D, Longley J, et al. Factors associated with preventable adverse drug reactions. Am J Hosp Pharm 1994; 51: 2268–72.PubMed Pearson T, Pittman D, Longley J, et al. Factors associated with preventable adverse drug reactions. Am J Hosp Pharm 1994; 51: 2268–72.PubMed
Metadata
Title
Postdischarge Adverse Drug Reactions in Primary Care Originating from Hospital Care in France
A Nationwide Prospective Study
Authors
Laurent Letrilliart
Thomas Hanslik
Michel Biour
Jean-Paul Fagot
Marguerite Guiguet
Dr Antoine Flahault
Publication date
01-08-2001
Publisher
Springer International Publishing
Published in
Drug Safety / Issue 10/2001
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.2165/00002018-200124100-00006

Other articles of this Issue 10/2001

Drug Safety 10/2001 Go to the issue