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Published in: BMC Health Services Research 1/2010

Open Access 01-12-2010 | Research article

Trends of adverse drug reactions related-hospitalizations in Spain (2001-2006)

Authors: Pilar Carrasco-Garrido, López Ana de Andrés, Valentín Hernández Barrera, Gil Ángel de Miguel, Rodrigo Jiménez-García

Published in: BMC Health Services Research | Issue 1/2010

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Abstract

Background

Adverse drug reactions (ADR) are a substantial cause of hospital admissions. We conducted a nationwide study to estimate the burden of hospital admissions for ADRs in Spain during a six-year period (2001-2006) along with the associated total health cost.

Methods

Data were obtained from the national surveillance system for hospital data (Minimum Basic Data Set) maintained by the Ministry of Health and Consumer Affairs, and covering more than 95% of Spanish hospitals. From these admissions we selected all hospitalization that were code as drug-related (ICD-9-CM codes E), but intended forms of overdoses, errors in administration and therapeutics failure were excluded. The average number of hospitalizations per year, annual incidence of hospital admissions, average length of stay in the hospital, and case-fatality rate, were calculated.

Results

During the 2001-2006 periods, the total number of hospitalized patients with ADR diagnosis was 350,835 subjects, 1.69% of all acute hospital admissions in Spain. The estimated incidence of admissions due to ADR decreased during the period 2001-2006 (p < 0.05). More than five percent of patients (n = 19,734) died during an ADR-related hospitalization. The drugs most commonly associated with ADR-related hospitalization were antineoplastic and immunosuppressive drugs (n = 75,760), adrenal cortical steroids (n = 47,539), anticoagulants (n = 26,546) and antibiotics (n = 22,144). The costs generated by patients in our study increased by 19.05% between 2001 and 2006.

Conclusions

Approximately 1.69% of all acute hospital admissions were associated with ADRs. The rates were much higher for elderly patients. The total cost of ADR-related hospitalization to the Spanish health system is high and has increased between 2001 and 2006. ADRs are an important cause of admission, resulting in considerable use of national health system beds and a significant number of deaths.
Literature
1.
go back to reference Waller P: Pharmacoepidemiology-a tool for public health. Pharmacoepidemiol Drug Saf. 2001, 10 (2): 165-72. 10.1002/pds.579.CrossRefPubMed Waller P: Pharmacoepidemiology-a tool for public health. Pharmacoepidemiol Drug Saf. 2001, 10 (2): 165-72. 10.1002/pds.579.CrossRefPubMed
2.
go back to reference De Abajo F: Medications as a solution and a problem for public health. Brief overview of the pharmacoepidemiologic objectives. Rev Esp Salud Publica. 2001, 75 (4): 281-3.CrossRefPubMed De Abajo F: Medications as a solution and a problem for public health. Brief overview of the pharmacoepidemiologic objectives. Rev Esp Salud Publica. 2001, 75 (4): 281-3.CrossRefPubMed
3.
go back to reference Kohn LT, Corrigan JM, Donaldson MS: To Err is Human: Building a Safer Health System. 2000, Institute of Medicine: Washington DC Kohn LT, Corrigan JM, Donaldson MS: To Err is Human: Building a Safer Health System. 2000, Institute of Medicine: Washington DC
4.
go back to reference Van der Hooft CS, Sturkenboom MC, van Grootheest K, Kingma HJ, Stricker BH: Adverse drug reaction-related hospitalisations: a nationwide study in The Netherlands. Drug Saf. 2006, 29 (2): 161-8. 10.2165/00002018-200629020-00006.CrossRefPubMed Van der Hooft CS, Sturkenboom MC, van Grootheest K, Kingma HJ, Stricker BH: Adverse drug reaction-related hospitalisations: a nationwide study in The Netherlands. Drug Saf. 2006, 29 (2): 161-8. 10.2165/00002018-200629020-00006.CrossRefPubMed
5.
go back to reference Kongkaew C, Noyce PR, Ashcroft DM: Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. Ann Pharmacother. 2008, 42 (7): 1017-25. 10.1345/aph.1L037.CrossRefPubMed Kongkaew C, Noyce PR, Ashcroft DM: Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. Ann Pharmacother. 2008, 42 (7): 1017-25. 10.1345/aph.1L037.CrossRefPubMed
6.
go back to reference Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, Farrar K, Park BK, Breckenridge AM: Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ. 2004, 329 (7456): 15-9. 10.1136/bmj.329.7456.15.CrossRefPubMedPubMedCentral Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, Farrar K, Park BK, Breckenridge AM: Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ. 2004, 329 (7456): 15-9. 10.1136/bmj.329.7456.15.CrossRefPubMedPubMedCentral
7.
go back to reference Van der Hooft CS, Dieleman JP, Siemes C, Aarnoudse AJ, Verhamme KM, Stricker BH, Sturkenboom MC: Adverse drug reaction-related hospitalisations: a population-based cohort study. Pharmacoepidemiol Drug Saf. 2008, 17 (4): 365-71. 10.1002/pds.1565.CrossRefPubMed Van der Hooft CS, Dieleman JP, Siemes C, Aarnoudse AJ, Verhamme KM, Stricker BH, Sturkenboom MC: Adverse drug reaction-related hospitalisations: a population-based cohort study. Pharmacoepidemiol Drug Saf. 2008, 17 (4): 365-71. 10.1002/pds.1565.CrossRefPubMed
8.
go back to reference Trifirò G, Calogero G, Ippolito FM, Cosentino M, Giuliani R, Conforti A, Venegoni M, Mazzaglia G, Caputi AP: Adverse drug events in emergency department population: a prospective Italian study. Pharmacoepidemiol Drug Saf. 2005, 14 (5): 333-40. 10.1002/pds.1074.CrossRefPubMed Trifirò G, Calogero G, Ippolito FM, Cosentino M, Giuliani R, Conforti A, Venegoni M, Mazzaglia G, Caputi AP: Adverse drug events in emergency department population: a prospective Italian study. Pharmacoepidemiol Drug Saf. 2005, 14 (5): 333-40. 10.1002/pds.1074.CrossRefPubMed
9.
go back to reference Queneau P, Bannwarth B, Carpentier F, Guliana JM, Bouget J, Trombert B, Leverve X, Lapostolle F, Borron SW, Adnet F: Association Pédagogique Nationale pour l'Enseignement de la Thérapeutique (APNET). Emergency department visits caused by adverse drug events: results of a French survey. Drug Saf. 2007, 30 (1): 81-8. 10.2165/00002018-200730010-00008.CrossRefPubMed Queneau P, Bannwarth B, Carpentier F, Guliana JM, Bouget J, Trombert B, Leverve X, Lapostolle F, Borron SW, Adnet F: Association Pédagogique Nationale pour l'Enseignement de la Thérapeutique (APNET). Emergency department visits caused by adverse drug events: results of a French survey. Drug Saf. 2007, 30 (1): 81-8. 10.2165/00002018-200730010-00008.CrossRefPubMed
10.
go back to reference Onder G, Pedone C, Landi F, Cesari M, Della Vedova C, Bernabei R, Gambassi G: Adverse drug reactions as cause of hospital admissions: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). Am Geriatr Soc. 2002, 50 (12): 1962-8. 10.1046/j.1532-5415.2002.50607.x.CrossRef Onder G, Pedone C, Landi F, Cesari M, Della Vedova C, Bernabei R, Gambassi G: Adverse drug reactions as cause of hospital admissions: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). Am Geriatr Soc. 2002, 50 (12): 1962-8. 10.1046/j.1532-5415.2002.50607.x.CrossRef
11.
go back to reference Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, Small SD, Sweitzer BJ, Leape LL: The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group. 1997, JAMA, 277 (4): 307-11. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, Small SD, Sweitzer BJ, Leape LL: The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group. 1997, JAMA, 277 (4): 307-11.
12.
go back to reference Senst BL, Achusim LE, Genest RP, Cosentino LA, Ford CC, Little JA, Raybon SJ, Bates DW: Practical approach to determining costs and frequency of adverse drug events in a health care network. Am J Health Syst Pharm. 2001, 58 (12): 1126-32.PubMed Senst BL, Achusim LE, Genest RP, Cosentino LA, Ford CC, Little JA, Raybon SJ, Bates DW: Practical approach to determining costs and frequency of adverse drug events in a health care network. Am J Health Syst Pharm. 2001, 58 (12): 1126-32.PubMed
13.
go back to reference Rockett IR, Putnam SL, Jia H, Chang CF, Smith GS: Unmet substance abuse treatment need, health services utilization, and cost: a population-based emergency department study. Ann Emerg Med. 2005, 45 (2): 118-27. 10.1016/j.annemergmed.2004.08.003.CrossRefPubMed Rockett IR, Putnam SL, Jia H, Chang CF, Smith GS: Unmet substance abuse treatment need, health services utilization, and cost: a population-based emergency department study. Ann Emerg Med. 2005, 45 (2): 118-27. 10.1016/j.annemergmed.2004.08.003.CrossRefPubMed
17.
go back to reference WHO: Collaborating center for international drug monitoring. International monitoring of adverse reaction to drug:adverse reaction terminology. 1980, DEM/NC/81.30; 31. XXI WHO: Collaborating center for international drug monitoring. International monitoring of adverse reaction to drug:adverse reaction terminology. 1980, DEM/NC/81.30; 31. XXI
18.
go back to reference Brvar M, Fokter N, Bunc M, Mozina M: The frequency of adverse drug reaction related admissions according to method of detection, admission urgency and medical department specialty. BMC Clin Pharmacol. 2009, 9 (8). Brvar M, Fokter N, Bunc M, Mozina M: The frequency of adverse drug reaction related admissions according to method of detection, admission urgency and medical department specialty. BMC Clin Pharmacol. 2009, 9 (8).
20.
go back to reference Navarro-Calderón E, Navarro MJ, Muelas J, Escoms V, Salazar A: Utilidad del CMBD en la declaración de efectos adversos a medicamentos. Boletín epidemiológico. Centro Nacional de Epidemiología. 2003, 11 (23): 265-276. Navarro-Calderón E, Navarro MJ, Muelas J, Escoms V, Salazar A: Utilidad del CMBD en la declaración de efectos adversos a medicamentos. Boletín epidemiológico. Centro Nacional de Epidemiología. 2003, 11 (23): 265-276.
21.
go back to reference Alexopoulou A, Dourakis SP, Mantzoukis D, Pitsariotis T, Kandyli A, Deutsch M, Archimandritis AJ: Adverse drug reactions as a cause of hospital admissions: a 6-month experience in a single center in Greece. Eur J Intern Med. 2008, 19 (7): 505-10. 10.1016/j.ejim.2007.06.030.CrossRefPubMed Alexopoulou A, Dourakis SP, Mantzoukis D, Pitsariotis T, Kandyli A, Deutsch M, Archimandritis AJ: Adverse drug reactions as a cause of hospital admissions: a 6-month experience in a single center in Greece. Eur J Intern Med. 2008, 19 (7): 505-10. 10.1016/j.ejim.2007.06.030.CrossRefPubMed
22.
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): 1200-5. 10.1001/jama.279.15.1200.CrossRefPubMed Lazarou J, Pomeranz BH, Corey PN: Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998, 279 (15): 1200-5. 10.1001/jama.279.15.1200.CrossRefPubMed
23.
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): 46-54. 10.1023/A:1015570104121.CrossRefPubMed Beijer HJ, de Blaey CJ: Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies. Pharm World Sci. 2002, 24 (2): 46-54. 10.1023/A:1015570104121.CrossRefPubMed
24.
go back to reference Zhang M, Holman CD, Preen DB, Brameld K: Repeat adverse drug reactions causing hospitalization in older Australians: a population-based longitudinal study 1980-2003. Br J Clin Pharmacol. 2007, 63 (2): 163-70. 10.1111/j.1365-2125.2006.02839.x.CrossRefPubMed Zhang M, Holman CD, Preen DB, Brameld K: Repeat adverse drug reactions causing hospitalization in older Australians: a population-based longitudinal study 1980-2003. Br J Clin Pharmacol. 2007, 63 (2): 163-70. 10.1111/j.1365-2125.2006.02839.x.CrossRefPubMed
25.
go back to reference Samoy LJ, Zed PJ, Wilbur K, Balen RM, Abu-Laban RB, Roberts M: Drug-related hospitalizations in a tertiary care internal medicine service of a Canadian hospital: a prospective study. Pharmacotherapy. 2006, 26 (11): 1578-86. 10.1592/phco.26.11.1578.CrossRefPubMed Samoy LJ, Zed PJ, Wilbur K, Balen RM, Abu-Laban RB, Roberts M: Drug-related hospitalizations in a tertiary care internal medicine service of a Canadian hospital: a prospective study. Pharmacotherapy. 2006, 26 (11): 1578-86. 10.1592/phco.26.11.1578.CrossRefPubMed
26.
go back to reference Howard RL, Avery AJ, Slavenburg S, Royal S, Pipe G, Lucassen P, Pirmohamed M: Which drugs cause preventable admissions to hospital? A systematic review. Br J Clin Pharmacol. 2007, 63 (2): 136-47. 10.1111/j.1365-2125.2006.02698.x.CrossRefPubMed Howard RL, Avery AJ, Slavenburg S, Royal S, Pipe G, Lucassen P, Pirmohamed M: Which drugs cause preventable admissions to hospital? A systematic review. Br J Clin Pharmacol. 2007, 63 (2): 136-47. 10.1111/j.1365-2125.2006.02698.x.CrossRefPubMed
27.
go back to reference Martín MT, Codina C, Tuset M, Carné X, Nogué S, Ribas J: Drug related problems as a cause of hospital admission. Med Clin (Barc). 2002, 118 (6): 205-10.CrossRef Martín MT, Codina C, Tuset M, Carné X, Nogué S, Ribas J: Drug related problems as a cause of hospital admission. Med Clin (Barc). 2002, 118 (6): 205-10.CrossRef
28.
go back to reference Lema Devesa MC: Economics, health and health care. 2003, Neurologia, 18 (4): 57-63. Lema Devesa MC: Economics, health and health care. 2003, Neurologia, 18 (4): 57-63.
29.
go back to reference Librero J, Peiró S, Ordiñana R: Chronic comorbility and homogeneity in diagnostic related groups. Gac San. 1999, 13 (4): 292-302.CrossRef Librero J, Peiró S, Ordiñana R: Chronic comorbility and homogeneity in diagnostic related groups. Gac San. 1999, 13 (4): 292-302.CrossRef
Metadata
Title
Trends of adverse drug reactions related-hospitalizations in Spain (2001-2006)
Authors
Pilar Carrasco-Garrido
López Ana de Andrés
Valentín Hernández Barrera
Gil Ángel de Miguel
Rodrigo Jiménez-García
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2010
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-10-287

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