Hassan Y, Al-Ramahi R J, Aziz N A, Ghazali R
School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
Int J Clin Pharmacol Ther. 2010 Sep;48(9):571-6. doi: 10.5414/cpp48571.
Adverse drug events (ADEs) are a common cause of hospitalization and in-hospital complications. The aim of this study was to determine the rates, types, severity and preventability of pre-admission and in-hospital ADEs in patients with chronic kidney disease (CKD).
This study was conducted at the nephrology unit at Penang General Hospital. A random sample of 300 adult patients with CKD was included. Medical records and charts were reviewed by a clinical pharmacist every work day to find any evidence of errors or complications related to drug use. If a suspected ADE was found, further investigations were carried out to assess the causality, severity and preventability of the event.
A total of 159 ADEs were reported in 122 (40.7%) of the patients. We found 86 suspected pre-admission ADEs in 68 (22.7%) of the patients. These were either the cause of admission for some patients or discovered by the initial physical examination and laboratory investigations. During hospitalization, 64 (21.3%) patients had 73 suspected ADEs. Out of the total 159 suspected ADEs, it was highly probable that 31 events were due to medication, while 61 were of lower probability, and 67 were merely possible. A total of 48 (30.2%) events was considered preventable. 46 events (28.9%) were serious, 93 (58.5%) were less serious and 20 (12.6%) were insignificant. The medication classes most frequently involved in ADEs were diuretics, antibacterials, drugs used for diabetes mellitus, antithrombotic agents, mineral supplements and antihypertensive drugs.
ADEs are very common in hospitalized CKD patients, and some of these events are preventable. The service of a clinical pharmacist may help to reduce ADEs.
药物不良事件（ADEs）是住院及院内并发症的常见原因。本研究旨在确定慢性肾脏病（CKD）患者入院前及住院期间ADEs的发生率、类型、严重程度及可预防性。
本研究在槟城总医院肾病科进行。纳入300例成年CKD患者的随机样本。临床药师每个工作日查阅病历和图表，以查找与药物使用相关的任何错误或并发症证据。若发现疑似ADEs，进一步调查以评估事件的因果关系、严重程度及可预防性。
122例（40.7%）患者共报告159例ADEs。我们在68例（22.7%）患者中发现86例疑似入院前ADEs。这些对部分患者而言是入院原因，或通过初次体格检查及实验室检查发现。住院期间；64例（21.3%）患者发生73例疑似ADEs。在总共159例疑似ADEs中，31例事件很可能由用药引起，61例可能性较低，67例仅为可能。共48例（30.2%）事件被认为可预防。46例（28.9%）事件严重，93例（58.5%）不太严重，20例（12.6%）不严重。ADEs中最常涉及的药物类别为利尿剂、抗菌药物、糖尿病用药、抗血栓药物、矿物质补充剂及抗高血压药物。
ADEs在住院CKD患者中非常常见，其中一些事件是可预防的。临床药师的服务可能有助于减少ADEs。
