评估三级转诊中心急诊科出现的药物不良反应的患病率和经济负担:一项前瞻性研究。

K J Patel, M S Kedia, D Bajpai, S S Mehta, N A Kshirsagar, N J Gogtay
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引用次数: 142

摘要

背景:药物不良反应(adr)现在被认为是住院的重要原因,其比例在0.9-7.9%之间。它们也构成了重大的经济负担。因此,我们旨在确定印度某三级转诊中心急诊科(ED)出现的不良反应的患病率和经济负担。方法:2005年对成年患者进行为期6周的前瞻性观察性研究。采用标准标准评估不良反应的发生率、医院的经济负担、严重程度和可预防性。结果:研究期间共有6899例患者就诊。其中,2046人因各种原因被录取。共有265/6899例患者出现不良反应(3.84%)。共有141/265人因adr入院,因此adr作为入院原因占总入院人数的6.89%。大多数(74.71%)为中度。最常见的不良反应是抗结核药物引起的肝毒性、华法林毒性和氯喹引起的胃炎。中位住院时间为5天[95% CI 5.37, 7.11],每位患者的平均住院费用为6197卢比/-(150美元)。总adr中,59.62%(158/265)是绝对或潜在可避免的。结论:本研究表明,不良反应导致住院的发生率较高,并构成重大的经济负担。对患者和开处方者进行培训,可减少因可避免的不良反应而住院的人数,从而减轻他们的经济负担。
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Evaluation of the prevalence and economic burden of adverse drug reactions presenting to the medical emergency department of a tertiary referral centre: a prospective study.

Background: Adverse drug reactions (ADRs) are now recognized as an important cause of hospital admissions, with a proportion ranging from 0.9-7.9%. They also constitute a significant economic burden. We thus aimed at determining the prevalence and the economic burden of ADRs presenting to Medical Emergency Department (ED) of a tertiary referral center in India

Methods: A prospective, observational study of adult patients carried out over a 6 week period in 2005. The prevalence of ADRs, their economic burden from the hospital perspective, severity, and preventability were assessed using standard criteria.

Results: A total 6899 patients presented during the study period. Of these, 2046 were admitted for various reasons. A total of 265/6899 patients had ADRs (3.84 %). A total of 141/265 was admitted due to ADsR, and thus ADRs as a cause of admissions were 6.89% of total admissions. A majority (74.71%) were found to be of moderate severity. The most common ADRs were anti-tubercular drug induced hepatotoxicity, warfarin toxicity and chloroquine induced gastritis. The median duration of hospitalization was 5 days [95% CI 5.37, 7.11], and the average hospitalization cost incurred per patient was INR 6197/- (USD 150). Of total ADRs, 59.62% (158/265) were found to be either definitely or potentially avoidable.

Conclusion: The study shows that ADRs leading to hospitalization are frequent and constitute a significant economic burden. Training of patients and prescribers may lead to a reduction in hospitalization due to avoidable ADRs and thus lessen their economic burden.

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