Asio Lillian, Nasasira Marble, Kiguba Ronald
Department of Pharmacology and Therapeutics, College of Health Sciences, Makerere University, Kampala, Uganda.
Child and Family Foundation Uganda, Kampala, Uganda.
Ther Adv Drug Saf. 2023 Jul 29;14:20420986231188842. doi: 10.1177/20420986231188842. eCollection 2023.
Adverse drug reactions (ADRs) contribute to the burden of disease globally and of particular concern are ADR-related hospital admissions.
This study sought to determine the burden, characteristics, contributing factors and patient outcomes of ADRs that were the primary diagnosis linked to hospital admission among inpatients in Uganda.
We conducted a cross-sectional secondary analysis of data from a prospective cohort study of adult inpatients aged 18 years and older at Uganda's Mulago National Referral Hospital from November 2013 to April 2014.
We reviewed clinical charts to identify inpatients with an ADR as one of the admitting diagnoses and, if so, whether or not the hospital admission was primarily attributed to the ADR. Logistic regression was used to determine factors associated with hospital admissions primarily attributed to ADRs.
Among 762 inpatients, 14% had ADRs at hospital admission and 7% were primarily hospitalized due to ADRs. A total of 235 ADRs occurred among all inpatients and 57% of the ADRs were the primary diagnosis linked to hospital admission. The majority of ADRs occurred in people living with HIV and were attributed to antiretroviral drugs. HIV infection [aOR (adjusted odds ratio) = 2.97, 95% confidence interval (CI): 1.30-6.77], use of antiretroviral therapy (aOR = 5.46, 95% CI: 2.56-11.68), self-medication (aOR = 2.27, 95% CI: 1.14-4.55) and higher number of drugs used (aOR = 1.13, 95% CI: 1.01-1.26) were independently associated with hospital admissions attributed to ADRs.
Antiretroviral drugs were often implicated in ADR-related hospital admissions. HIV infection (whether managed by antiretroviral therapy or not), self-medication and high pill burden were associated with hospital admissions attributable to ADRs. The high HIV burden in Sub-Saharan Africa increases the risk of ADR-related hospitalization implying the need for emphasis on early detection, monitoring and appropriate management of ADRs associated with hospital admission in people living with HIV.
药物不良反应（ADR）在全球疾病负担中占一定比例，与ADR相关的住院情况尤其令人关注。
本研究旨在确定乌干达住院患者中以ADR作为主要诊断且与住院相关的ADR的负担、特征、促成因素及患者结局。
我们对2013年11月至2014年4月在乌干达穆拉戈国家转诊医院对18岁及以上成年住院患者进行的一项前瞻性队列研究的数据进行了横断面二次分析。
我们查阅临床病历，以确定将ADR作为入院诊断之一的住院患者，若为这种情况，则确定住院是否主要归因于ADR。采用逻辑回归分析来确定与主要归因于ADR的住院相关的因素。
在762名住院患者中，14%在入院时发生了ADR，7%主要因ADR住院。所有住院患者共发生235例ADR，其中57%的ADR是与住院相关的主要诊断。大多数ADR发生在艾滋病毒感染者中，且归因于抗逆转录病毒药物。艾滋病毒感染[调整优势比（aOR）=2.97，95%置信区间（CI）：1.30 - 6.77]、抗逆转录病毒治疗的使用（aOR = 5.46，95% CI：2.56 - 11.68）、自我用药（aOR = 2.27，95% CI：1.14 - 4.55）以及使用药物数量较多（aOR = 1.13，95% CI：1.01 - 1.26）与归因于ADR的住院独立相关。
抗逆转录病毒药物常与ADR相关的住院有关。艾滋病毒感染（无论是否接受抗逆转录病毒治疗）、自我用药和高药物负担与归因于ADR的住院有关。撒哈拉以南非洲地区艾滋病毒负担较高，增加了ADR相关住院的风险，这意味着需要强调对艾滋病毒感染者中与住院相关的ADR进行早期检测、监测和适当管理。
