Retrospective analysis of adverse drug reaction enquiries to a hospital drug information service: lessons to be learned to increase in-hospital drug safety.

IF 1.5 Q3 PHARMACOLOGY & PHARMACY International Journal of Pharmacy Practice Pub Date : 2024-09-03 DOI:10.1093/ijpp/riae036
Dorothea Strobach, Yvonne Pudritz, Daniela Huttner
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Abstract

Objectives: Adverse drug reactions (ADRs) are a major drug safety concern and a frequent topic of enquiries to hospital drug information services. Our goal was to analyse these enquiries regarding background, complexity, nature of ADR, and involved drug classes to improve in-hospital drug safety.

Methods: Retrospectively, ADR enquiries to a German university hospital pharmacy drug information 2018-2022 were analysed regarding enquirer (profession, medical specialty) and enquiry details (drugs, suspected ADR/enquiry prior to drug initiation, ADR system organ class, probable cause identified, and enquiry complexity).

Key findings: Of 543 enquiries, 516 (95%) were asked by physicians, 493 (91%) patient-specific, 390 (71%) on suspected ADRs, and 153 (28%) prior to drug initiation. Enquiries originated frequently from internal medicine (74/13.6%), paediatrics (71/13.1%), neurology (70/12.9%), and haemato-oncology (62/11.4%). Most frequent ADRs were haematologic (94/17%) and hepatic (72/13%). The median number of drugs per enquiry was three (range 0-37), 209 (38%) enquiries referred to one specific drug, 165 (30%) concerned ≥11 drugs. A probable cause for suspected ADRs was identified in 75 (36%) enquiries concerning one drug and 155 (94%) with ≥11 drugs. Most frequent drugs were antineoplastic (54/25.8%), nervous-system-drugs (42/20.1%), and anti-infective (40/19.1%). Most enquiries (342/63%) were complex (multiple/specialist resources).

Conclusions: Enquiries were usually asked by physicians referring to suspected ADRs in specific clinical situations. A probable cause was identified in many cases pointing to a direct positive impact on patient care. Enquiries prior to drug initiation should be encouraged to increase drug safety. Information on main ADR effects and drug classes helps with targeted counselling.

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对医院药物信息服务机构药物不良反应查询的回顾性分析:提高院内用药安全的经验教训。
目的:药物不良反应(ADRs)是一个主要的药物安全问题,也是医院药物信息服务部门经常询问的问题。我们的目标是分析这些咨询的背景、复杂性、ADR 的性质以及涉及的药物类别,以改善院内用药安全:回顾性分析了2018-2022年德国一所大学医院药房药物信息的ADR查询,包括查询者(职业、医学专业)和查询详情(药物、用药前疑似ADR/查询、ADR系统器官类别、已确定的可能原因和查询复杂性):在 543 项咨询中,516 项(95%)由医生提出,493 项(91%)针对特定患者,390 项(71%)针对疑似 ADR,153 项(28%)在用药前提出。询问者主要来自内科(74/13.6%)、儿科(71/13.1%)、神经内科(70/12.9%)和血液肿瘤科(62/11.4%)。最常见的不良反应是血液病(94/17%)和肝病(72/13%)。每次询问涉及的药物数量中位数为 3 种(范围 0-37),209 次(38%)询问涉及一种特定药物,165 次(30%)询问涉及的药物数量≥11 种。有 75 项(36%)查询涉及一种药物,有 155 项(94%)查询涉及≥11 种药物,这些查询确定了疑似药物不良反应的可能原因。最常见的药物是抗肿瘤药物(54/25.8%)、神经系统药物(42/20.1%)和抗感染药物(40/19.1%)。大多数查询(342/63%)都很复杂(多种/专家资源):结论:查询通常是由医生在特定临床情况下提出的疑似药物不良反应。在许多情况下都能找到可能的原因,这对患者护理产生了直接的积极影响。应鼓励在用药前进行询问,以提高用药安全性。有关药物不良反应主要影响和药物类别的信息有助于提供有针对性的咨询。
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来源期刊
CiteScore
2.90
自引率
5.60%
发文量
146
期刊介绍: The International Journal of Pharmacy Practice (IJPP) is a Medline-indexed, peer reviewed, international journal. It is one of the leading journals publishing health services research in the context of pharmacy, pharmaceutical care, medicines and medicines management. Regular sections in the journal include, editorials, literature reviews, original research, personal opinion and short communications. Topics covered include: medicines utilisation, medicine management, medicines distribution, supply and administration, pharmaceutical services, professional and patient/lay perspectives, public health (including, e.g. health promotion, needs assessment, health protection) evidence based practice, pharmacy education. Methods include both evaluative and exploratory work including, randomised controlled trials, surveys, epidemiological approaches, case studies, observational studies, and qualitative methods such as interviews and focus groups. Application of methods drawn from other disciplines e.g. psychology, health economics, morbidity are especially welcome as are developments of new methodologies.
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