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乌干达一家国家级转诊医院成年住院患者中抗高血压药、抗血栓药和抗糖尿病药不良反应的流行病学研究

Epidemiology of adverse drug reactions to antihypertensive, antithrombotic and antidiabetic medications among adult inpatients at a National Referral Hospital, Uganda.

作者信息

Kuteesa Jonathan, Nasasira Marble, Kiguba Ronald

机构信息

Department of Pharmacology and Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda.

Research and Data Centre, Child and Family Foundation, Kampala, Uganda.

出版信息

Expert Opin Drug Saf. 2024 Jan;23(1):129-136. doi: 10.1080/14740338.2023.2244421. Epub 2023 Aug 8.

Abstract

INTRODUCTION

Treatment for hypertension, thrombosis and type 2 diabetes mellitus is long term and usually requires a combination of drugs which increases the risk of adverse drug reactions (ADRs). This study aimed to establish the prevalence at admission, incidence during hospitalization and characteristics of ADRs linked to antihypertensive, antithrombotic and antidiabetic drugs among adult inpatients in Uganda.

METHODS

We conducted a secondary analysis of data from a previously assembled prospective cohort study in Uganda's Mulago National Referral Hospital. We reviewed the files of inpatients who received antihypertensive, antithrombotic and/or antidiabetic medications prior to and/or during hospitalization. The modified Schumock and Thornton Preventability Scale, the Division of AIDS Table for Grading the Severity of Adult and Paediatric Adverse Events and the World Health Organization - Uppsala Monitoring Centre seriousness criteria were used to characterize the ADRs.

RESULTS

More than a quarter (27%, 42/155) of the inpatients experienced an ADR at admission or during hospitalization. The point prevalence of ADRs at admission was 8% (13/155) and the incidence of ADRs during hospitalization was 23% (36/155). Forty-one percent (35/86) of the ADRs were serious and the majority (59%, 51/86) were preventable.

CONCLUSION

One in 13 inpatients experienced an ADR on admission and one in four experienced an ADR that developed during hospitalization. Clinicians ought to prescribe medicines with lower ADR risk profile for cardiovascular and/or diabetic patients whenever possible.

摘要

引言

高血压、血栓形成和2型糖尿病的治疗是长期的,通常需要联合用药,这增加了药物不良反应(ADR)的风险。本研究旨在确定乌干达成年住院患者中与抗高血压、抗血栓和抗糖尿病药物相关的ADR在入院时的患病率、住院期间的发生率及其特征。

方法

我们对乌干达穆拉戈国家转诊医院之前进行的一项前瞻性队列研究的数据进行了二次分析。我们查阅了在住院前和/或住院期间接受抗高血压、抗血栓和/或抗糖尿病药物治疗的住院患者档案。采用改良的舒莫克和桑顿可预防性量表、成人及儿童不良事件严重程度分级的艾滋病司表格以及世界卫生组织-乌普萨拉监测中心的严重性标准来描述ADR。

结果

超过四分之一(27%,42/155)的住院患者在入院时或住院期间发生了ADR。入院时ADR的时点患病率为8%(13/155),住院期间ADR的发生率为23%(36/155)。41%(35/86)的ADR是严重的,大多数(59%,51/86)是可预防的。

结论

每13名住院患者中就有1名在入院时发生ADR,每4名住院患者中就有1名在住院期间发生ADR。临床医生应尽可能为心血管和/或糖尿病患者开具ADR风险较低的药物。

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