Effects of the number of drugs used on the prevalence of adverse drug reactions in children

Mayuko Sugioka,Takuya Matsuyama,Aisa Koyama,Azusa Murayama,Chitoshi Goto,Satoshi Aoyama,Takashi Mizui,Tomoya Tachi,Hayato Katsuno,Masahiro Yasuda,Hitomi Teramachi,Tomohiro Osawa,Yoshihiro Noguchi

doi:10.1038/s41598-020-78358-3

Mayuko Sugioka, Takuya Matsuyama + Show 11 more

Open Access

https://doi.org/10.1038/s41598-020-78358-3

Copy DOI

Abstract

In pediatric individuals, polypharmacy would increase the prevalence of adverse drug reactions (ADRs). However, there is no report on the ADR increase adjusted for the influence of concomitant disease types. We conducted a retrospective study in pediatric patients to determine whether polypharmacy is a risk factor for ADR development, after the adjustment. Patients aged 1–14 years on medication who visited Gifu Municipal Hospital (Gifu, Japan) were included. We evaluated patient characteristics, ADR causality, ADR classification and severity, and ADR-causing drugs. We examined the association between ADR prevalence and number of drugs used. We performed multiple logistic regression analyses to investigate risk factors for ADR development. Of 1330 patients, 3.5% sought medical attention for ADRs. ADR causality was most often assessed as “possible,” with gastrointestinal ADRs being the most common. Grade 1 ADRs were the most and antibiotics were the most common suspected ADR-inducing drug. The multiple logistic regression analysis showed that ≥ 2 or ≥ 4 drug use, neoplasms, mental and behavioral disorders, and circulatory system diseases significantly increased ADR prevalence. Polypharmacy increased the prevalence of ADR resulting in hospital visits in children, after adjusting for the influence of disease types. Therefore, proactive polypharmacy control measures are necessary for children.

Highlights

In pediatric individuals, polypharmacy would increase the prevalence of adverse drug reactions (ADRs)
The objectives of this study were to evaluate the prevalence of ADRs in pediatric outpatients and hospitalized patients and determine whether pediatric polypharmacy is a risk factor for hospital visits and hospitalizations owing to ADRs
We conducted a retrospective study on the association between polypharmacy and the prevalence of ADRs in pediatric patients who visited a hospital or were hospitalized

Summary

Introduction

Polypharmacy would increase the prevalence of adverse drug reactions (ADRs). Polypharmacy increased the prevalence of ADR resulting in hospital visits in children, after adjusting for the influence of disease types. Another study conducted in Germany demonstrated that, according to a multivariate analysis, the prevalence of ADRs in children (≤ 17 years of age) taking four or more drugs in non-institutionalized settings was significantly higher than that in children taking one drug[17]. These studies considered the effect of the health status, but not the effect of the disease types of the enrolled pediatric patients. We conducted a retrospective study on the association between polypharmacy and the prevalence of ADRs in pediatric patients who visited a hospital or were hospitalized

Objectives

Methods

Results

Conclusion