adverse reactions/interactions HOW MAI\JY HOSPITAL ADMISSIONS ARE DUE TO DRUG REACTIONS? The association between hospital admissions and drug-related problems was studied in 216 patients admitted to a general 100-bed ward in a large teaching hospital over a 2-month period. They were interviewed to find out prescription and non-prescription drugs regularly used, method of administration, compliance with prescribed therapy, and signs and symptoms of adverse drug reactions.
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59 (27. 3%) of patients had a drug-related problem associated with hospital admission, adverse drug reactions and noncompliance being the principai drug-reiated factors. • 24 ( l l. I %) had experienced an adverse reaction to at least one drug associated with their hospital admission, but in only 17 (7.9% of the 216)did the adverse reaction cause the admission. Most reactions were moderate, but 4 were life threatening. Diuretics and digitalis glycosides were the most commonly implicated classes of drugs. e Medical problems associated with non-compliance caused admission in 23 (I 0.5% ). All drugs implicated were being used for maintenance therapy of chronic diseases- anticonvulsant and antidiabetic medications in nearly 50%. • Overdoses of aspirin (2 patients), 'Mercresin' (I) and tranquillisers and antidepressants were suicide attempts ( 1 successful). e Improper or erroneous drug U:se and inadequate therapy were responsible for a few admissions. 'While hospita!"pharmacists have traditionally concentrated on improving inpatient distribution services, this study indicates a need for the improvement of drug monitoring and educational services available to patients in outpatient settings'. McKenney, J.M. and Harrison. W.L.: American Journal of Hospital Pharmacy 33: 792 (Aug 1976)
... And How Many End In Death? During a three and a half year study, of 7423 hospital admissions 1328 adverse drug reactions were detected in 928 patients and 16 (0.22%) patients died of drug-associated causes. I. 7% of patients with adverse drug reactions died. The general mortality among all all patients was 6.5%. Ten (62.5%) of the 16 patients who died of drug-associated causes were admitted with the drug reaction; the remainder developed the reaction in hospital. Eleven (6 8. 8 %) patients who died of drug -related causes had been deemed terminally ill; the rest seriously ill. Antineoplastic drugs, azathioprine, and prednisone, were implicated in half of the fatalities, heparin sodium caused 3, and aspirin (-indomethacin in I) caused 2. Extrapolation from the available data to a national incidence of drug -related deaths is not possible. Caranos, G.J. et al.: Archives of Internal Medicine 136: 827 (Aug 1976)
INPHARMA 6th November, "1976 p4
