Negative results related to drugs required in hospitalisation

Santamaría-Pablos, A.; Redondo-Figuero, C.; Baena, M.I.; Faus, M.J.; Tejido, R.; Acha, O.; Novo, F.J.

doi:10.1016/S2173-5085(09)70064-4

Farmacia Hospitalaria

ISSN: 1130-6343

Farmacia Hospitalaria (Farm Hosp) is the official publication of the Spanish Society of Hospital Pharmacists (SEFH), a professional and scientific organization that currently has about 4.351 members.

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To assess the prevalence of negative clinical outcomes associated with medication as a cause of hospital admission and to determine their characteristics (types, categories, avoidability, severity, and the drug groups involved). To determine possible risk factors related to the appearance of this problem.

Method

An observational study carried out over a 3 month period in a department of the university hospital, 163 patients were selected at random. The information obtained from the patient interview, the revision of clinical records and clinical sessions were used to then identify negative clinical outcomes using the Dader method.

Results

In 27 cases (16.6%; 95% confidence interval [CI], 1.6–23.0), negative clinical outcomes associated with medication were considered to be the main cause of hospital admission. The most frequent negative clinical outcomes associated with medication were untreated health problems, non-quantitative ineffectiveness, and quantitative safety problems respectively. The overall prevalence of preventable admissions due to negative clinical outcomes associated with medication was 88.9%; (95% CI, 71.9–96.1). With regards to severity, 74.1% (95% CI, 55.3–86.1) of the total admissions were moderate. The most common drugs implicated in hospital admissions were: antibacterial for systemic use, cardiovascular, and non steroidal anti-inflammatory agents. Apart from age, no other factors were found for hospital admissions due to negative results associated with medication.

Conclusions

Negative clinical outcomes associated with medication as cause of hospital admission are a prevalent problem and most of them are avoidable with pharmacotherapeutic follow-up.

Keywords:

Adverse effects

Adverse effects from medication

Hospital admission

Negative results associated with medication

Resumen

Objetivo

Estimar la prevalencia de resultados negativos asociados a medicamentos como causa de ingreso hospitalario y determinar sus características (dimensiones, tipos, evitabilidad, gravedad y grupos terapéuticos implicados). Buscar posibles factores asociados a la aparición de este problema.

Método

Estudio observacional transversal, durante 3 meses, en una unidad del hospital universitario, seleccionando al azar mediante el método de extracción de bolas de una urna a 163 pacientes.

La información obtenida de la entrevista con el paciente, de la revisión de historias clínicas y la procedente de las sesiones clínicas se empleaba para la identificación posterior de los resultados negativos asociados con medicamentos mediante el método Dáder.

Resultados

En 27 de los 163 pacientes estudiados (16,6 %; intervalo de confianza [IC] del 95 %, 1,6–23,0), el ingreso fue causado principalmente por un resultado negativo asociado con los medicamentos. Los pacientes ingresaron por problemas de salud no tratados, inefectividades no cuantitativas e inseguridades cuantitativas respectivamente. Un 88,9 % (IC del 95 %, 71,9–96,1) de los ingresos por resultados negativos asociados con medicamentos fueron evitables. En cuanto a la gravedad, el 74,1 % (IC del 95 %, 55,3–86,1) fueron moderados. Los principales grupos farmacológicos implicados en los ingresos fueron antiinfecciosos sistémicos, fármacos relacionados con el aparato cardiovascular y antiinfl amatorios no esteroideos. A excepción de la edad, no se encontraron factores asociados a la aparición de ingresos por resultados negativos asociados con medicamentos.

Conclusiones

Los ingresos por resultados negativos asociados con medicamentos son un problema de elevada prevalencia y la mayoría son evitables mediante seguimiento farmacoterapéutico.

Palabras clave:

Efectos adversos

Acontecimientos adversos por medicamentos

Ingresos hospitalarios

Resultados negativos asociados con medicamentos

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