tailieunhanh - Adverse drug reactions in hospital patients: A systematic review of the prospective and retrospective studies

Translational medicine requires the full extent of patient data to be accessible so that questions spanning multiple data sources, such as those discussed above, can be asked and answered. For example, a physician in clinical practice would like to easily ask for the criteria for the diagnosis of a disease and the recommendations for perso- nalized medicines. However, TMKB has the potential to be equally relevant to scien- tists developing new pharmaceutical products. While simple questions may be answered by queries on a single data set, other scientific questions may be addressed only when diverse data sets are fully integrated [38]. Importantly, answering more sophisticated questions may require. | Bandolier Extra Evidence-based health care June 2002 Adverse drug reactions in hospital patients A systematic review of the prospective and retrospective studies Philip Wiffen BPharm Regional Pharmaceutical Advisor SERO Mike Gill FRCP Director of Public Health SERO Jayne Edwards DPhil Research Associate Andrew Moore DSc Director of Research NHS Executive South East 40 Eastbourne Terrace London W2 3QR Pain Research Nuffield Department of Anaesthetics University of Oxford Oxford Radcliffe Hospitals Churchill Hospital Headington Oxford OX3 7LJ Executive Summary Adverse drug reactions ADRs in hospital are a significant cause of morbidity and mortality. We have examined the literature for evidence 1 To estimate incidence of ADRs causing hospital admission or occurring whilst in hospital in the UK and in other countries. 2 To estimate the burden of ADRs lengthened hospital stay cost capacity for the UK. 3 To identify risk factors for ADRs. 4 To identify research into means of reducing adverse drug reactions. We found a large literature with 108 primary studies involving 412 000 patients. ADR incidence was lower since 1985 than before 1985. Across all studies since 1985 there was considerable consistency. Information from the UK was sparse but indicated that the UK was similar to Europe with ADRs affecting about 7 of patients or admissions. Rates in North America were half those in Europe before and after 1985. The overall ADR impact on England is therefore estimated to be 4 out of 100 hospital bed-days about 15-20 400-bed hospital equivalents at a cost of about 380 million a year to the NHS in England. One in 10 of all NHS bed days are taken up by the consequences of ADR or hospital acquired infection. Factors associated with increased incidence of ADR were increasing age especially over 70 years increasing number of medicines and particular classes of medicine. Antibiotics anticoagulants digoxin diuretics hypoglycaemic agents and NSAIDs are responsible for between 60 .