Adverse Drug Reaction Monitoring in a North Indian Public Teaching Hospital

P. Tiwari, Anuradha, S. D’Cruz, A. Sachdev
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引用次数: 5

Abstract

Background: ADRs are a significant cause of morbidity and mortality. Hospital-based monitoring is one of the methods to identify and assess the ADRs. The aim of this study is to monitor the incidence, causality, preventability and severity of ADRs occurring in the wards of a public teaching hospital. Method: A prospective-observational study was conducted in medical wards of a public teaching hospital to assess the Causality, level of severity and preventability of identified ADRs. All the relevant information was collected from patients’ record file in a standard case record form. To find out the incidence of ADRs between different gender and age groups, chi- square was applied. Results: 60 ADRs in 56 patients were detected in 520 patients admitted to the hospital. The most commonly occurring ADRs were constipation, hypokalemia and diarrhea. Most troublesome classes of drugs contributing to adverse drug reactions were antibiotics. All the ADRs were Type ‘A’ reaction (100%). According to Naranjo’s ADR probability scale, 13% ADRs were ‘possible’ and 87% ADRs were ‘probable’. Severity assessment, using Modified Hartwig criteria, showed that 53% ADRs were mild and 47% ADRs were moderate respectively. Preventability of ADRs was assessed using modified Shumock and Thornton method; and, it was found that all the 95% ADRs were not preventable. Conclusion: The results of this study concluded that adverse drug reactions were significant cause of increase burden on health care system, decrease quality of life, and increase hospitalizations. The results would help in the early detection and to ensure safer drug therapy.
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北印度公立教学医院药物不良反应监测
背景:不良反应是发病率和死亡率的重要原因。基于医院的监测是识别和评估不良反应的方法之一。本研究旨在监测某公立教学医院病房发生的不良反应的发生率、因果关系、可预防性和严重程度。方法:对某公立教学医院内科病房进行前瞻性观察研究,评估已发现的不良反应的因果关系、严重程度和可预防性。所有相关信息均以标准病例记录表从患者病历档案中收集。为了了解不同性别和年龄组的不良反应发生率,我们采用卡方分析。结果:520例住院患者中检出56例60例不良反应。最常见的不良反应是便秘、低钾血症和腹泻。引起药物不良反应的最棘手的一类药物是抗生素。adr均为A型反应(100%)。根据Naranjo的ADR概率量表,13%的ADR是“可能的”,87%的ADR是“可能的”。采用Modified Hartwig标准进行严重程度评估,分别显示53%的adr为轻度,47%的adr为中度。采用改良的Shumock - Thornton法评价不良反应的可预防性;95%的不良反应都是不可预防的。结论:药物不良反应是增加卫生保健系统负担、降低生活质量、增加住院率的重要原因。该结果将有助于早期发现并确保更安全的药物治疗。
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