Posthumus Anke A G, Alingh Carien C W, Zwaan Christian C M, van Grootheest Kees K, Hanff Lidwien L M, Witjes Bregje B C M, 't Jong Geert W, de Hoog Matthijs
Erasmus MC, Rotterdam, The Netherlands.
BMJ Open. 2012 Aug 24;2(4). doi: 10.1136/bmjopen-2012-000934. Print 2012.
To investigate the incidence and characteristics of hospital admissions related to adverse drug events in the paediatric setting.
Prospective single-centre study.
A secondary and tertiary paediatric care centre.
A total of 683 acutely admitted patients, aged 0-18 year. All acutely admitted patients, using medication before admission, were prospectively screened for possible Adverse Drug Reactions (ADR)-related admission with a trigger list. Included cases were analysed with the Naranjo score for the assessment of causality.
This research explored the incidence of ADR-related admissions and investigated the relation between ADR and the licensing status of the medicines, as well as the severity and potential to prevent the ADRs.
A total of 683 patients were admitted acutely during the study period, 47 of them were exposed to cancer chemotherapy. Fifteen patients not exposed to chemotherapy (2.4%) were admitted due to an ADR. Five of these 15 ADRs (33%) were caused by unlicensed or off-label used drugs. Thirty-two patients exposed to chemotherapy (68.1%) were admitted due to an ADR; 27 of these (84%) were caused by unlicensed or off-label used drugs.
In conclusion, this study shows that ADR-related hospital admissions occur more frequently in the paediatric population compared with adults, and more frequently in patients exposed to cancer chemotherapy. No relation was found between the unlicensed and off-label used drugs and the incidence of ADRs.
调查儿科环境中与药物不良事件相关的住院发生率及特征。
前瞻性单中心研究。
一家二级和三级儿科护理中心。
共683例急性入院患者,年龄0至18岁。所有入院前使用药物的急性入院患者均使用触发清单进行前瞻性筛查,以确定是否可能因药物不良反应(ADR)入院。纳入病例使用纳伦霍评分进行因果关系评估分析。
本研究探讨了与ADR相关的入院发生率,并调查了ADR与药物许可状态之间的关系,以及ADR的严重程度和预防可能性。
研究期间共683例患者急性入院,其中47例接受癌症化疗。15例未接受化疗的患者(2.4%)因ADR入院。这15例ADR中有5例(33%)由未获许可或未按说明书使用的药物引起。32例接受化疗的患者(68.1%)因ADR入院;其中27例(84%)由未获许可或未按说明书使用的药物引起。
总之,本研究表明,与成人相比,儿科人群中与ADR相关的住院更为常见,且在接受癌症化疗的患者中更为频繁。未发现未获许可和未按说明书使用的药物与ADR发生率之间存在关联。