Effect Of Adverse Drug Reactions Research Articles

Effects of Adverse Drug Reactions and Adverse Drug Events in Hospital Admission Rates and Re-Hospitalization of Patients

Abstract Background: ADRs and ADEs have a great potential to hospitalize and/or re-hospitalize patients. According to McDonnell and Jacobs, one ADR or ADE could lead a patient to a hospital length of stay of an average of 6.1 days. This can lead to lost days of work, a longer recovery time and even economic implications. Methods: A thorough evaluation of the relevant extracted literature has been analyzed thoroughly in order to find out how ADRs and ADEs impact the levels of hospitalization and re-hospitalization of patients and whether strategies, such as reporting systems, can aide in decreasing their overall occurrence. Results: As the level of hospital admissions/re-hospitalizations due to ADRs and ADEs depends on different factors, such as age and location, the data is separated in the following categories: pediatric population, general adult populations and geriatric population. Where data were available, location has been specified within each category as well. Conclusion: ADR and ADE-related hospital admission and readmission rates are age-group related, elderly being at the highest risk. However, these rates are not dependent on whether a country is developed or developing. Also, there are strategies that can be utilized by healthcare providers in order to decrease these rates in the future, such as to provide medication reviews and follow-ups.

Prediction of adverse effects of drug-drug interactions on the cardiovascular system based on the analysis of structure-activity relationships

The co-administration of drugs often leads to drug-drug interactions, which may be accompanied by various adverse drug reactions that pose a threat to the life and health of patients. The effect caused by adverse drug reactions from the cardiovascular system is one of the most significant manifestations of drug-drug interaction. Clinical assessment of adverse drug reactions resulting from drug-drug interaction between all drug pairs used in therapeutic practice is not possible. The purpose of this work was to build models using structure-activity analysis to predict the effects of adverse drug reactions on the cardiovascular system, mediated by interactions between drug pairs when they are taken together. Data on adverse effects resulting from drug-drug interaction were obtained from the DrugBank database. The data on drug pairs that do not cause the corresponding effects, necessary for building accurate structure-activity models, were obtained from the TwoSides database, which contains the results of the analysis of spontaneous reports. Two types of descriptors were used to describe a pair of drug structures: PoSMNA descriptors and probabilistic estimates of the prediction of biological activities obtained using the PASS program. Structure-activity relationships were established using the Random Forest method. Prediction accuracy was calculated by means of a five-fold cross-validation. The highest accuracy values were obtained using PASS probabilistic estimates as descriptors. The area under the ROC curve was 0.94 for bradycardia, 0.96 for tachycardia, 0.90 for arrhythmia, 0.90 for ECG QT prolongation, 0.91 for hypertension, 0.89 for hypotension.

Effects of Adverse Drug Reactions and Adverse Drug Events in Hospital Admission Rates and Re-Hospitalization of Patients

Background: ADRs and ADEs have a great potential to hospitalize and/or re-hospitalize patients. According to McDonnell and Jacobs, one ADR or ADE could lead a patient to a hospital length of stay of an average of 6.1 days. This can lead to lost days of work, a longer recovery time and even economic implications. Methods: A thorough evaluation of the relevant extracted literature has been analyzed thoroughly in order to find out how ADRs and ADEs impact the levels of hospitalization and re-hospitalization of patients and whether strategies, such as reporting systems, can aide in decreasing their overall occurrence. Results: As the level of hospital admissions/re-hospitalizations due to ADRs and ADEs depends on different factors, such as age and location, the data is separated in the following categories: pediatric population, general adult populations and geriatric population. Where data were available, location has been specified within each category as well. Conclusion: ADR and ADE-related hospital admission and readmission rates are age-group related, elderly being at the highest risk. However, these rates are not dependent on whether a country is developed or developing. Also, there are strategies that can be utilized by healthcare providers in order to decrease these rates in the future, such as to provide medication reviews and follow-ups.

Assessing the prevalence and effect of adverse drug reactions among patients receiving first line anti-tubercular medicines in the Tamale Teaching Hospital, Ghana.

Introductiontuberculosis (TB) remains a global major health problem, especially in developing countries. Although treatment regimen for TB has been highly effective, treatment-related adverse effects account for significant morbidity leading to reduced effectiveness of therapy and high default rate. This study evaluated the nature and occurrence of Adverse Drug Reactions (ADRs) in patients receiving first line antitubercular therapy (ATT) in Tamale Teaching Hospital (TTH) and its effects on adherence.Methodsthe study was a cross-sectional study for a period of six months. A total of 66 participants who were on first line antituberculotic therapy consented for the study. Data was collected using a questionnaire and analysed using SPSS version 22.0.Resultsabout 77% (n=51) of the participants had experienced ADRs. Gastrointestinal symptoms were the most commonly reported symptoms of ADR (80%, n=41). Regarding adherence, over half (51.0%, n=26) said the occurrence of the Adverse Drug Reaction had affected the manner in which they take their medications. Of these, 84.6% (n=22) of the participants indicated that they skipped/missed their medications and 15.4% stopped the medication entirely. About 39.2% (n=20) reported ADRs to a healthcare practitioner and 60.8% did not. All the reported cases were managed by a health practitioner using another medication.Conclusionthe study showed that ADRs are common among patients receiving first line ATT. Gastrointestinal tract (GIT) related ADRs were the most common. Adherence to first line antitubercular therapy is poor as a result of adverse drugs reaction.

Strategies and methods to improve compliance in special patient groups and with specific health problems

Adherence to long-term treatments for chronic conditions remains a challenging issue in general medicine. A low proportion of patients follow the recommendations from general practitioners. The attention of all recurrent or chronic health problems and turning points of natural or physiological situations but that present medical health risks requires co-operation with patients and changes in behavior. Taking into account the complexity of the phenomenon of therapeutic compliance, it is necessary to individualize the strategies of approach in general medicine. Some strategies and methods to increase compliance are: 1. Rapport and continuity of care; 2. Confidentiality; 3. Prevention of effects of adverse drug reactions on compliance; 4. Simplify the therapeutic regimen; 5. Self-monitoring; 6. Avoid giving the impression that the drug replaces the need for changes in habits; 7. Know the patient’s agenda, the perceptions of the disease, and the importance and their confidence about adherence; 8. Involve the patient in the decision; and 9. Motivational interview and negotiation. Emphasis should be placed on the importance of doctor-patient relationship and continuity of care, as well as knowing the patient’s agenda, but other strategies are presented according to specific groups of patients and diseases and risk factors, as: 1) Cardiovascular risk factors and coronary heart disease; 2) Hypertension; 3) Hyperlipidemia; 4) Diabetes mellitus; 5) HIV; 6) Osteomuscular diseases; 7) Contraception; 8) Gastroenterological diseases; 9) Psychiatric diseases; 10) Bronchial asthma and chronic obstructive pulmonary disease; 11) Kidney diseases; 12) Elders; 13) Teenagers; and 14) Disabled people. Multiple strategies are probably necessary in most cases.

The effects of adverse drug reactions on patients’ satisfaction: Evidence from publicly available data on Tamiflu (oseltamivir)

BackgroundDespite the fact that user-generated data are widely used in medical informatics in general and for revealing side-effects of various pharmaceuticals in particular, recent studies have focused merely on methods of extracting information on side effects from unstructured or semi-structured reviews of specific medications without linking side effects to any outcomes. ObjectivesIn this study we demonstrate how user-generated online content on side effects experienced by patients while taking a pharmaceutical product can be used to do research after the drug has been introduced to the market, thus allowing to complement the results of official clinical studies and market research. In particular, we concentrate on revealing the contribution of various side effects to reported customer satisfaction with Tamiflu, a popular antiviral drug. MethodsPublicly available data from an online platform with reviews from patients are used as an input to the analysis that applies statistical and machine learning methods (multivariate logit models and classification trees) to investigate the relationships of side effects to demographic characteristics and to the overall satisfaction with the medication. ResultsWe prioritized side effects of Tamiflu based on the significance of their association with patient’s ratings published at one of the well-known drug discussion forums. Among all types of side effects used in our study, the neuropsychiatric symptoms and body pain are the most influential, followed by skin problems. Specific combinations of side-effects that are associated with low satisfaction were detected. ConclusionThe proposed analytical approach can help pharmaceutical companies to improve their products and/or medical guidelines associated with their products and figure out fighting which adverse effects should be given a priority from the customer satisfaction perspective.

Using Social Media for Effective Health Care Service Delivery: Bibliometrics and Sociometry

Abstract Background: Today, social media seems to be a common forum for sharing information, discuss ideas and knowledge. The number of social media users are at increasing trend even in developing countries. The importance of using social media, especially in delivering healthcare services information, include the creation of awareness and firsthand information of health and health-related issues (effect of adverse drug reactions, reporting, among others). Purpose: The main objective of this work is to outline and discuss the opportunities and challenges of using social media in the health area. Specifically, the objectives of this paper are to compare the role of health professionals and consumers with special reference to social media; detect the validity of the information available in social media, and understand how to deal with incorrect/false information, and to analyze the main characteristics of the publications on the subject social media in healthcare. Methods: This article is a narrative review, also a descriptive quantitative research, using the techniques of bibliometrics and sociometry in order to obtain information relevant to the subject in question. Results: The results presented the countries, researchers and universities that produced the most on the subject, and demonstrated the efficiency of bibliometrics and sociometry techniques for health research, going beyond a narrative review. Conclusion: It is concluded that social media is a competitive differential in the provision of health services. To this end, institutions should empower their employees, encourage them to seek and convey reliable and accurate information, monitor routines, and evaluate results through user feedback. Suggestion: To this end, institutions should empower their employees, encourage them to seek and convey reliable and accurate information, monitor routines, and evaluate results through user feedback.

The observed effect of adverse drug reactions on the length of hospital stay among medical inpatients in a Nigerian University Teaching Hospital

Background:The potential impact of an adverse drug reaction (ADR) is multidimensional, and includes prolonged length of hospitalization which significantly increased morbidity, mortality, and economic burden with additional intense medical care.Aim:This study was designed to characterize and evaluate the potential effect of ADRs on the length of hospital stay among adult medical inpatients in an academic teaching hospital in a large West African nation. The overarching goal of the study is to highlight approaches toward mitigating the sequelae of ADRs in this setting, and improving their recognition and timely optimal management.Methods:The patients admitted into the adult medical wards of a Nigerian University Teaching Hospital over a 9-month period from December 2013 to August 2014 were prospectively recruited for the study and followed up till discharge.Results:A total of 507 patients were evaluated during the study, out of which 269 (53.1%) of them were males and 238 (46.9%) were females. The mean age of the study population was 48.9 ± 17.8 years (median of 46 years). In this study, the mean duration of hospital stay for all patients was 11.9 ± 11.3 days (median of 9 days). Females had a mean duration stay of 12.9 ± 12.3 days (median of 10 days) and stayed significantly longer than males who stayed a mean duration of 10.9 ± 10.2 days with a median of 7 days ( t = −1.985, df = 505, p = 0.048). Furthermore, patients admitted solely because of ADRs (ADR-out) had a significantly shorter duration of stay with a mean duration stay of 6.1 ± 3.7 days (median duration stay of 7 days) when compared to those without ADRs whose mean duration of stay was 11.6 ± 11.0 days (median duration stay of 8 days), and this was found to be statistically significant ( t = 2.110, df = 472, p = 0.035). Those patients who developed ADRs during admission (ADR-in) had a mean duration of stay of 18.3 ± 14.8 (median of 15 days). This was significantly longer than the duration of stay for patients without ADRs ( t = −3.398, df = 487, p = 0.001) and also significantly longer than the duration for those who were admitted solely because of ADRs ( t =3.432, df = 49, p = 0.001).Conclusion:In this study, ADRs were associated with a significantly prolonged length of hospital stay for adult medical inpatients in this Nigerian University Teaching Hospital.

Use of bedaquiline and delamanid in diabetes patients: clinical and pharmacological considerations.

Antituberculosis (anti-TB) treatment may be affected by both diabetes and hypoglycemic agents in patients with these 2 comorbidities. However, data supporting this conclusion relate only to standard anti-TB therapies. Sirturo® (bedaquiline) and Deltyba® (delamanid), novel drugs for multidrug-resistant tuberculosis (MDR-TB), are recommended for diabetes patients when another effective treatment regimen cannot be provided. Currently, there are no clinical data related to the use of these agents in diabetes patients. Possible alterations in the pharmacokinetics of these novel drugs induced by changes in subcutaneous adipose blood flow, gastric emptying, or nephropathy in diabetes patients, and possible drug–drug interactions with hypoglycemic agents, are of special interest, since the efficacy of bedaquiline and delamanid is concentration dependent. Moreover, it is of fundamental importance to avoid possible additive or synergistic effects of adverse drug reactions in this already vulnerable patient group. We reviewed clinical particularities related to the use of bedaquiline and delamanid in patients with type 1 and 2 diabetes mellitus (DM), as well as pharmacological aspects of the concurrent use of these agents with oral and injectable hypoglycemic agents. Bedaquiline shares liver metabolic pathways with several oral hypoglycemic agents, whereas delamanid may compete with several oral hypoglycemic agents and insulin analogs at protein-binding sites. Special concern exists regarding the use of bedaquiline and delamanid in diabetes patients aged >65 years and patients with severe renal or hepatic impairment or electrolyte disturbances. Concurrent use of bedaquiline and delamanid with insulin analogs, and other hypoglycemic agents that prolong the heart rate-corrected QT interval, such as sulfonylureas and glinides, may enhance this adverse reaction. Hepatic-related adverse reactions may develop more frequently when these drugs are combined with thiazolidinediones and acarbose. Data from Phase III and postmarketing studies are needed to elucidate the effect of DM and hypoglycemic agents on bedaquiline and delamanid effects in MDR-TB patients.

DI-105 Epidemiological monitoring of adverse drug reactions in paediatric emergency departments

BackgroundThe use of drugs in children presents several problems of safety and tolerability, mainly due to lack of information about the risk-benefit profile in real conditions of use. Pharmacovigilance could...

Managing hypertension in the very elderly: effect of adverse drug reactions (ADRs) on achieving targets

The Hypertension in the Very Elderly trial (HYVET), demonstrated the benefit of antihypertensive treatment in patients >or=80 years. However, patients in this age group are at increased risk of drug interactions and adverse effects. We conducted a retrospective cohort study, in hypertensive patients aged >or=80 years, to determine whether it is possible to follow the HYVET guidelines in an everyday clinical setting. We identified 100 patients aged >or=80 years referred to the Hypertension Clinic, University Hospital Birmingham, over a 10-year period. Most patients were referred to the clinic because of poorly controlled blood pressure despite treatment and all had 24 h ambulatory blood pressure monitoring (ABPM) as part of their assessment. All patients tolerated ABPM, and a 'white coat' effect was demonstrated in 33 patients. In 64 out of 100 patients (57 on treatment), the ABPM confirmed poor blood pressure control. Despite this, 26 of these patients had an antihypertensive either stopped (15), and /or reduced (3) or left unchanged (9) at clinic because of documented adverse drug reactions (ADRs). In 36 out of 100 patients, no additional antihypertensive therapy was needed because the blood pressure was either well-controlled on treatment (28), over-treated (4), or normotensive with a white coat effect (4). Despite this, antihypertensive agents were either stopped (10), and or reduced (5) because of ADRs in half the patients (14) from the well-controlled group. In conclusion, 40% patients had documented ADRs overall which limited further intervention, suggesting that implementation of the HYVET recommendations in clinical practice may be difficult.

Dolantin tramadol hydrochloride and the treatment of renal colic compared to observe the effect

Objective To observe the dolantin and tramadol hydrochloride for renal colic pain of the clinical results.Methods 84 cases of renal colic were randomly divided into groups of 42 cases of dolantin,tramadol hydrochloride group of 42 cases,respectively,to give dolantin and analgesic tramadol hydrochloride.Use VRSs-4 and NRS analysis of the two drugs after the analgesic effect of adverse drug reactions observed at the same time.Results Group dolantin analgesic effect and the onset time is better than tramadol hydrochloride group (P<O.OS).Conclusions Dolantin tramadol hydrochloride and the treat-ment of renal colic have a therapeutic effect,the group is better than dolantin tramadol hydrochloride group,but should pay attention to their adverse reactions. Key words: Dolantin; Tramadol hydrochloride Renal colic

A quantitative approach of using genetic algorithm in designing a probability scoring system of an adverse drug reaction assessment system

Background The detrimental effects of adverse drug reactions (ADRs) are well established. Hence, precise and accurate assessment of ADRs’ causality which can differentiate signal from noise is crucial in screening, management and minimisation of ADRs. Objective The current study reported our attempt to improve the scoring system of a previously published algorithm of ADR assessment by our group using a genetic algorithm approach so that the final score can measure the probability of ADR causality. Design Using ADR cases obtained from the Centre for Drug Administration, the national centre for pharmacovigilance in Singapore, with known causality probability values as reference points, rules were developed to define possible combinations of criteria for ‘Definite’ ADR cases and ‘Probable’ ADR cases. A new scoring system was developed using these parameters with the help of genetic algorithm, and tested on 37 ‘Definite’ and 431 ‘Not Definite’ ADR cases. In addition, sensitivity and specificity analysis were performed to allow a comparison of performance between our algorithm and that used by the Adverse Drug Reaction Advisory Committee in Australia (ADRAC). Results The new scoring system is able to provide a probability of the causality of an ADR by a suspected drug. When applied to the ‘Definite’ and ‘Not Definite’ ADR reports, the new algorithm gave a sensitivity of 83.8% and specificity of 71.0%. Conclusions Using a quantitative method of assessing causality in the new algorithm allows rare and new ADRs to be more readily identified since a quantitative score can give a more precise degree of ADR causality. This scoring system that provides a probability score would help to make this algorithm more informative and assistive for clinicians, regulatory agencies or pharmaceutical companies to generate ADR alerts. The higher sensitivity value displayed by our algorithm also shows that it would be a good ADR screening tool.

Effect of adverse drug reactions on length of stay in surgical intensive care units.

To determine the frequency of adverse drug reactions in surgical intensive care units and evaluate their effect on the length of stay. Prospective cohort study. Between May 1997 and December 1999, while the patients were staying in the surgical intensive care unit, data were gathered regarding suspected adverse drug reactions and on different variables related to the length of stay. Surgical intensive care units of our hospital. A total of 401 patients hospitalized in the surgical intensive care unit. In 37 of the 401 patients seen (9.2%; 95% confidence interval, 6.6-12.5), 39 different adverse drug reactions were detected. The adverse drug reactions were most frequently caused by the following drugs: morphine hydrochloride (n = 13), meperidine hydrochloride (n = 9), and metamizole (n = 7). Five adverse drug reactions were severe, the suspected medication had to be discontinued in 14 cases, and new drugs were necessary to manage the adverse drug reaction in 28 cases. The crude estimation of the effect of adverse drug reactions performed on the length of stay with a bivariant regression model indicated that each adverse drug reaction was related to an increase of 3.39 days (95% confidence interval, 1.47-5.31) in the length of stay. This estimation was reduced to 2.31 days (95% confidence interval, 0.64-3.99) when considering other variables that might cause confusion for analysis, although it is still important. Adverse drug reactions are a significant clinical and economic problem in surgical intensive care units.

Effect of Adverse Drug Reactions on Length of Stay in Intensive Care Units

The objective of the present study was to determine the frequency of adverse drug reactions (ADRs) in intensive care units (ICUs) and to evaluate their effect on the length of stay. We performed a prospective study to detect ADRs in 420 patients hospitalised in 10 predetermined beds in the ICU of our hospital between the months of March and December 1996. While the patients were staying in the ICU, data was gathered regarding suspected ADRs and on different variables related to the length of stay. 96 different ADRs were detected in 85 of the 420 patients seen [20.2%, 95% confidence intervals (95% CI) 16.5 to 24.4]. The ADRs were most frequently caused by the following drugs: nitrates (n = 25), opiates (n = 21) and ultrashort-acting benzodiazepines (n = 10). Eight ADRs were severe, the suspected medication had to be discontinued in 51 cases and new drugs were necessary to manage the ADRs in 73 cases. The crude estimation of the effect of the number of ADRs performed with a bivariant regression model indicated that each ADR was related to a 2.38-day increase (95% CI 1.31 to 3.45) in the length of stay. Although this estimation was reduced to 1.76 days (95% CI 0.72 to 2.79), when other confounding variables associated with the length of stay were considered, it was still important.In conclusion, the ADRs were a significant clinical problem in the ICUs and were responsible for a significant increase in the length of stay.

Improving drug safety: a joint responsibility

Over the past decades, health care delivery has become more complex, and the traditional roles and relationships that structure this process have altered to allow new decision makers to enter the arena. Responsibility for drug safety, previously perceived by the public as belonging to regulatory bodies and physicians, has, in their eyes, now extended to the manufacturer. Increasingly, benefits from health-care goods must now be balanced against society'S demand for safety, and to this end data must be amassed and analyzed. The developing science of pharmacoepidemiology uses new technology, including data base linkages, to expand scientific knowledge on how drugs affect patients. More specifically, it monitors the effect of adverse drug reactions (ADR) in large populations, as well as determining the benefits that specific drugs yield in fighting specific ailments. The RAD-AR (Risk/Benefit Assessment of Drugs Analysis and Response) initiative was launched in 1988 by Ciba-Geigy to address the issue of drug safety, with the aim of studying and assessing drug risks and benefits, and communicating their findings to the public. In April 1988, representatives from 30 research-based pharmaceutical companies in North America, Europe and Japan, consumer organisations and the media gathered in Switzerland to participate in the first W olfsberg Conference on the perception and management of drug safety. Since then, there has been a full agenda of meetings, workshops and seminars held all over the world. Co-operative efforts between members have resulted in the design and implementation of new projects to promote drug safety in different countries. These have included the production of data resource handbooks now available for North America, the United Kingdom, Europe and Japan; these volumes list population and sample descriptions with demographic data, coding information for diagnosis, data linkage capabilities, the availability of data bases to

Effect of Adverse Drug Reactions on the Length of Hospitalization

Effect of Adverse Drug Reactions on the Length of Hospitalization