Malhotra S, Jain S, Pandhi P
Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Int J Clin Pharmacol Ther. 2001 Jan;39(1):12-8. doi: 10.5414/cpp39012.
OBJECTIVE: To analyze the contribution of adverse drug events (ADEs) to the overall number of visits to the medical emergency and to determine the proportion of events leading to hospital admissions. PATIENTS AND METHODS: All visits to the medical emergency were recorded in a prospective, non-interventional design study over a period of 8 months. The ADEs were divided into 5 categories: adverse drug reactions (ADRs), drug interactions, patient non-compliance, physician non-compliance, and drug overdose. The cases were then followed-up to assess the prorportion of ADEs lead to hospitaliztion. RESULTS: A total of 4764 patients were included in the study. 5.9% of all visits were considered to be drug-related. The highest percentage of ADEs was observed in the age group less than 20 and more than 80 years. ADRs accounted for 45% of all ADEs, followed by patient non-compliance (28%). Patient and physician non-compliance were the main causes of drug-related hospital admissions. 52% of all ADE-related visits and 55% of ADE-related admissions were considered to be preventable. Non-steroidal antiinflammatory agents, oral hypoglycemics and antitubercular drugs were responsible for 37% of all ADRs. Non-compliance was mainly seen in hypertensives, asthmatics and epileptics. CONCLUSION: ADEs account for a sizable proportion of all visits to a medical emergency unit and some are serious enough to require hospitaliztion. A large number of ADE-related visits and admissions are preventable which highlights the importance of public education on the proper use of drugs, and also the need for regulation of the practice of unregistered medical practitioners in developing countries.
目的:分析药物不良事件(ADEs)对医疗急诊就诊总数的影响,并确定导致住院的事件比例。 患者与方法:在一项为期8个月的前瞻性、非干预性设计研究中,记录了所有医疗急诊就诊情况。ADEs分为5类:药物不良反应(ADRs)、药物相互作用、患者不依从、医生不依从和药物过量。然后对这些病例进行随访,以评估导致住院的ADEs比例。 结果:本研究共纳入4764例患者。所有就诊中有5.9%被认为与药物有关。在年龄小于20岁和大于80岁的人群中观察到的ADEs比例最高。ADRs占所有ADEs的45%,其次是患者不依从(28%)。患者和医生不依从是药物相关住院的主要原因。所有与ADE相关的就诊中有52%以及与ADE相关的住院中有55%被认为是可预防的。非甾体抗炎药、口服降糖药和抗结核药占所有ADRs的37%。不依从主要见于高血压患者、哮喘患者和癫痫患者。 结论:ADEs在所有医疗急诊就诊中占相当大的比例,有些严重到需要住院治疗。大量与ADE相关的就诊和住院是可预防的,这凸显了公众教育正确用药的重要性,也凸显了发展中国家对无证行医者行医进行监管的必要性。
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