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01-04-2003 | Original Research Article

Lack of Awareness of Community-Acquired Adverse Drug Reactions Upon Hospital Admission

Dimensions and Consequences of a Dilemma

Authors: Dr Harald Dormann, Manfred Criegee-Rieck, Antje Neubert, Tobias Egger, Arnim Geise, Sabine Krebs, Thomas H. Schneider, Micha Levy, Eckhart G. Hahn, Kay Brune

Published in: Drug Safety | Issue 5/2003

Abstract

Objective: Adverse drug reactions (ADRs) are a well-known cause of hospital admission. Nevertheless a quantitative estimate of the preventability of and physicians’ awareness of these reactions is lacking.

Study Design and Methods: Using intensive bedside and computer-assisted drug surveillance methods a 13-month prospective pharmacoepidemiological survey was carried out on patients admitted to two medical wards of the Erlangen-Nuremberg University Hospital in Erlangen, Germany. This study aimed to define the incidence of preventable and unavoidable ADRs. In addition we investigated the awareness of the physicians to ADRs at the time of admission and the rate of contraindicated pre-admission prescriptions.

Results: In 78 (8.5%) of 915 (10.9%) admissions a total of 102 (42 preventable) community-acquired ADRs were detected on admission. In 45 (3.8%) of the admissions ADRs led directly to hospitalisation. 56.9% of the ADRs were not recognised by the attending physician on admission. Marked correlation was found between the awareness of ADRs and their probability and severity scores (r = 0.85 and r = 0.94, respectively; p < 0.05). The most frequently detected ADRs were due to direct toxicity and secondary pharmacological effects. Idiosyncratic reactions were often missed and 18.6% of all drugs prescribed prior to admission were contraindicated. Leading the list were diuretics, analgesics/NSAIDs and antipsychotics/sedatives.

Conclusions: Awareness of existing ADRs on hospital admission and appropriate prescribing prior to hospital admission require attention. Early detection of ADRs on hospital admission can be achieved by the use of computer support systems. Many ADRs could be prevented by adhering to indications and contraindications.

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Title: Lack of Awareness of Community-Acquired Adverse Drug Reactions Upon Hospital Admission
Dimensions and Consequences of a Dilemma
Authors: Dr Harald Dormann
Manfred Criegee-Rieck
Antje Neubert
Tobias Egger
Arnim Geise
Sabine Krebs
Thomas H. Schneider
Micha Levy
Eckhart G. Hahn
Kay Brune
Publication date: 01-04-2003
Publisher: Springer International Publishing
Published in: Drug Safety / Issue 5/2003
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI: https://doi.org/10.2165/00002018-200326050-00004

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Lack of Awareness of Community-Acquired Adverse Drug Reactions Upon Hospital Admission

Dimensions and Consequences of a Dilemma

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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