Keche Yogendra, Gaikwad Nitin, Dhaneria Suryaprakash
Department of Pharmacology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
J Family Med Prim Care. 2021 Jul;10(7):2541-2545. doi: 10.4103/jfmpc.jfmpc_2374_20. Epub 2021 Jul 30.
Adverse Drug Reactions (ADRs) can lead to significant morbidity, rarely mortality and financial burden over the patient. ADRs that can be prevented can be considered as form of medication error sometimes. This study assessed the preventability, predictability and severity of ADRs using different assessment scales.
ADR Monitoring Centre under newly established teaching hospital in Chhattisgarh collected ADR reports from different healthcare professionals during the period from November 2016 to November 2018. Analysis of the reported ADRs was done for their causality assessment, demographic details of patients, most common drug class responsible for the ADR. Seriousness and preventability of ADRs were analysed by using WHO Causality Scale and Modified Schumock and Thornton Scale respectively. Severity of ADRs was assessed by Modified Hartwig and Siegel Scale.
Totally 288 ADRs were reported in a 2-year period. 92.01% ADRs were non serious. 44.8% were mild, 53.81% moderate and 1.39% were severe ADRs. Causality assessment showed: 5.21% certain, 54.86% probable, 39.24% possible and 0.69% unlikely ADRs. Around 26% ADRs were definitely and probably preventable and 27.78% ADRs were predictable. The highest number (32.29%) of ADRs were reported to antimicrobials. 11.15% ADRs were reported to NSAIDs, in that 37.5% ADRs were due to NSAIDs combination.
Many ADRs in this study are non-serious, preventable and predictable. Management of such ADRs through therapeutic interventions would be beneficial in a better patient outcome. Multidisciplinary strategies involving physicians, pharmacists, other healthcare professionals and patient education and awareness about ADRs are needed for prevention of ADRs.
药物不良反应(ADR)可导致患者出现严重发病情况,极少导致死亡,并带来经济负担。有时可预防的ADR可被视为用药错误的一种形式。本研究使用不同评估量表评估了ADR的可预防性、可预测性及严重程度。
恰蒂斯加尔邦一家新成立的教学医院的ADR监测中心在2016年11月至2018年11月期间收集了来自不同医疗专业人员的ADR报告。对报告的ADR进行分析,以评估其因果关系、患者的人口统计学细节、导致ADR的最常见药物类别。分别使用世界卫生组织因果关系量表和改良的舒莫克和桑顿量表分析ADR的严重性和可预防性。使用改良的哈特维希和西格尔量表评估ADR的严重程度。
在两年期间共报告了288例ADR。92.01%的ADR不严重。44.8%为轻度,53.81%为中度,1.39%为重度ADR。因果关系评估显示:肯定的ADR占5.21%,很可能的占54.86%,可能的占39.24%,不太可能的占0.69%。约26%的ADR肯定或很可能是可预防的,27.78%的ADR是可预测的。报告的ADR中数量最多的(32.29%)是抗菌药物。11.15%的ADR是关于非甾体抗炎药(NSAIDs)的,其中37.5%的ADR是由NSAIDs联合用药引起的。
本研究中的许多ADR不严重、可预防且可预测。通过治疗干预对这类ADR进行管理将有利于改善患者预后。预防ADR需要多学科策略,包括医生、药剂师、其他医疗专业人员以及患者对ADR的教育和认知。