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Hospital re-admission associated with adverse drug reactions in patients over the age of 65 years

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Context

Adverse drug reactions (ADRs) are responsible for 5 % of hospital admissions, but hospital re-admission induced by ADRs remains poorly documented.

Objective

The aim of this study was to estimate the rate of hospital re-admission and the factors associated with re-admission in the patients over the age of 65 years. Secondary, we described the characteristics of cases of ADRs leading to re-admission for drugs other than chemotherapy agents.

Methods

Data were extracted from hospital discharge summaries provided by the Department of Medical Information of Toulouse University Hospital. All patients over the age of 65 years admitted to the hospital in 2010 for an ADR, identified from ICD-10 codes, were selected. All subsequent admissions of members of this cohort within 1 year of discharge following the index admission were reviewed retrospectively. The risk factors associated with hospital re-admission for ADRs were analyzed. Medical records were used for descriptive analysis of re-admission due to drugs other than chemotherapy agents.

Results

We found that 553 of the 1000 patients admitted for ADRs in 2010 were re-admitted to hospital within 1 year. Among them, 87 cases were re-admitted for ADRs (estimated rate of 87/1000 re-admission for an ADR within 1 year). A comparison of the patients re-admitted for ADRs (n = 87) with those of patients re-admitted for other causes (n = 410) suggested that only cancer increased the risk of re-admission for ADRs (OR = 7.69 [4.59–12.88] 95 % CI). ADRs due to the same drug combination were the suspected cause of repeat admission in half the cases (other than chemotherapy). Hospital re-admission was considered avoidable in four cases (22 %).

Conclusion

This study shows an estimated rate of re-admission for an ADR around 87/1000 within 1 year, and the same drug combination were the suspected cause of repeat admission in half the cases. At least, 11 % of cases were avoidable.

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References

  1. Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, Farrar K, Park K, Breckenridge AM (2004) Adverse drug reactions as a cause of admission to hospital: prospective analysis of 18820 patients. Br Med J 329:15–19

    Article  Google Scholar 

  2. Pouyanne P, Haramburu F, Imbs JL, Begaud B (2000) Admissions to hospital caused by adverse drug reactions: cross sectional incidence study. Br Med J 320:1036

    Article  CAS  Google Scholar 

  3. Kongkaew C, Noyce PR, Ashcroft DM (2008) Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. Ann Pharmacother 42:1017–1025

    Article  PubMed  Google Scholar 

  4. Bouvy JC, De Bruin ML, Koopmanschap MA (2015) Epidemiology of adverse drug reactions in Europe: a review of recent observational studies. Drug Saf 38:437–453

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Chan A, Soh D, Ko Y, Yu-Chu H, Chiang J (2014) Characteristics of unplanned hospital admissions due to drug-related problems in cancer patients. Support Care Cancer 22:1875–1881

    Article  PubMed  Google Scholar 

  6. Miranda V, Fede A, Nobuo M, Ayres V, Giglio A, Miranda M, Riechelmann RP (2011) Adverse drug reactions and drug interactions as causes of hospital admission in oncology. J Pain Symptom Manag 42:342–353

    Article  Google Scholar 

  7. van der Hooft CS, Dieleman JP, Siemes C, Aarnoudse AJ, Verhamme KM, Stricker BH, Sturkenboom MC (2008) Adverse drug reaction-related hospitalisations: a population-based cohort study. Pharmacoepidemiol Drug Saf 17:365–371

    Article  PubMed  Google Scholar 

  8. Zhang M, Holman DJ, Price SD, Sanfilipo FM, Preen DB, Bulsara MK (2009) Comorbidity and repeat admission to hospital for adverse drug reactions in older adults: retrospective cohort study. Br Med J 338:2752

    Article  Google Scholar 

  9. Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL (2006) National surveillance of emergency department visits for outpatient adverse drug events. JAMA 296:1858–1866

    Article  CAS  PubMed  Google Scholar 

  10. Benard-Laribière A, Miremont-SalameG P-PMC, Noize P, Harmburu F (2015) Incidence of hospital admissions due to adverse drug reactions in France: the EMIR study. Fundam Clin Pharmacol 29:106–111

    Article  PubMed  Google Scholar 

  11. Davies EC, Green CF, Mottram DR, Rowe PH, Pirmohamed M (2010) Emergency re-admissions to hospital due to adverse drug reactions within 1 year of the index admission. Br J Clin Pharmacol 70:749–755

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bonnet-Zamponi D, d’Arailh L, Konrat C, Delpierre S, Lieberherr D, Lemaire A, Tubach F (2013) Drug-related readmissions to medical units of older adults discharged from acute geriatric units: optimization of medication in AGE Multicenter—results of the randomized controlled trial. J Am Geriatr Soc 61:113–121

    Article  PubMed  Google Scholar 

  13. Hauviller L, Eyvrard F, Garnault V, Montastruc JL, Bagheri H (2012) Estimation of re-admission rate to hospital in old people due to adverse Drug reactions: Data in Toulouse University Hospital. Fundam Clin Pharmacol (suppl 1):23

  14. Weill A, Païta M, Tuppin P, Fagot JP, Neumann A, Simon D, Ricordeau P, Montastruc JL, Allemand H (2010) Benfluorex and valvular heart disease: a cohort study of a million people with diabetes mellitus. Pharmacoepidemiol Drug Saf 19:1256–1262

    Article  CAS  PubMed  Google Scholar 

  15. Gourbil M, Grandvuillemin A, Beyens MN, Massy N, Gras V, D’Amico A, Miremont-Salamé G, Petitpain N (2014) Thromboembolic events in women exposed to hormonal contraception or cyproterone acetate in 2012: a cross-sectional observational study in 30 French public hospitals. Drug Saf 37:262–289

    Article  Google Scholar 

  16. World Health Organization 2010 International statistical classification of diseases and related health problems, 10th version. Available at: www.who.int/classifications/icd.

  17. Lugardon S, Desboeuf K, Fernet P, Montastruc JL, Lapeyre-Mestre M (2006) Using a capture-recapture method to assess the frequency of adverse drug reactions in a French university. Br J Clin Pharmacol 62:225–231

    Article  PubMed  PubMed Central  Google Scholar 

  18. IR E, JK A (2000) Adverse drug reactions: definitions, diagnosis, and management. Lancet 356:1255–1259

    Article  Google Scholar 

  19. Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA (2004) New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J Clin Epidemiol 57:1288–1294

    Article  PubMed  Google Scholar 

  20. ATC/DDD Index 2013 (n.d.). Available: http://www.whocc.no/atc_ddd_index/.

  21. Bégaud B, Evreux JC, Jouglard J, Lagier G (1985) Imputation of the unexpected or toxic effects of drugs. Actualization of the Method Used in France Therapie 40:111–118

    PubMed  Google Scholar 

  22. Olivier P, Caron J, Haramburu F, Imbs J-L, Jonville-Béra A-P, Lagier G, et al. (2005) Validation of a measurement scale: example of a French adverse drug reactions preventability scale. Therapie 60:39–45

    Article  PubMed  Google Scholar 

  23. Sikdar KC, Dowden J, Alaghehbandan R, MacDonald D, Peter P, Gadag V (2012) Adverse drug reactions in elderly hospitalized patients: a 12-year population-based retrospective cohort study. Ann Pharmacother 46:960–971

    Article  PubMed  Google Scholar 

  24. Chaye H, Bernard M, Tubery M, Rousseau V, Ecoiffier M, Montastruc JL, Bagheri H (2015) Hospital readmission induced by adverse drug reaction: a pilot study in a post-emergency unit of a French university hospital. Rev Med Int 36:450–456

    Article  CAS  Google Scholar 

  25. Von Euler M, Eliasson E, Öhlén G, Bergman U (2006) Adverse drug reactions causing hospitalization can be monitored from computerized medical records and thereby indicate the quality of drug utilization. Pharmacoepidemiol Drug Saf 15:179–184

    Article  Google Scholar 

  26. Onder G, Pedone C, Landi F, Cesari M, Della Vedova C, Bernabei R, et al. (2002) Adverse drug reactions as cause of hospital admissions: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). J Am Geriatr Soc 50:1962–1968

    Article  PubMed  Google Scholar 

  27. Jonville-Béra AP, Saissi H, Bensouda-Grimaldi L, Beau-Salinas F, Cissoko H, Giraudeau B, Autret-Leca E (2009) Avoidability of adverse drug reactions spontaneously reported to a French regional drug monitoring centre. Drug Saf 32:429–440

    Article  PubMed  Google Scholar 

  28. Kanagaratnam L, Abou Taam M, Heng M, De Boissieu P, Roux MP, Trenque T (2015) Serious adverse drug reaction and their preventability in the elderly over 65 years. Therapie 70:477–484

    Article  PubMed  Google Scholar 

  29. Répartition des séjours dans les établissements de soins de courte durée MCO selon le sexe, l’âge des patients et la pathologie traitée. (2010). Available at: http://www.datadrees.sante.gouv.fr/tableViewer/table/View.aspx?Reportld=1265

  30. Detournay B, Fagnani F, Pouyanne P, Haramburu F, Begaud B, Welsch M, Imbs JL (2000) Cost of hospitalizations for adverse drug effects. Therapie 55:137–139

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Service de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de Pharmacovigilance, de Pharmacoépidémiologie et d’Informations sur le Médicament, Faculté de Médecine de l’Université Paul Sabatier-, INSERM U1027, 37 Allées Jules Guesde, 31000, Toulouse, France

    Laurent Hauviller, Frédéric Eyvrard, Vanessa Rousseau, Jean Louis Montastruc & Haleh Bagheri

  2. Département d’Informations Médicales, CHU Toulouse, Hôtel Dieu St Jacques, 2 Rue Viguerie, 31300, Toulouse, France

    Valérie Garnault & L. Molinier

Authors
  1. Laurent Hauviller
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  2. Frédéric Eyvrard
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  3. Valérie Garnault
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  4. Vanessa Rousseau
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  5. L. Molinier
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  6. Jean Louis Montastruc
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  7. Haleh Bagheri
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Corresponding author

Correspondence to Haleh Bagheri.

Electronic supplementary material

Supplementary material

Table 2 Characteristics of 18 cases of hospital re-admission associated to Adverse Drug Reactions other than those related to antineoplastic agents. (PDF 41 kb)

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Hauviller, L., Eyvrard, F., Garnault, V. et al. Hospital re-admission associated with adverse drug reactions in patients over the age of 65 years. Eur J Clin Pharmacol 72, 631–639 (2016). https://doi.org/10.1007/s00228-016-2022-4

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  • DOI: https://doi.org/10.1007/s00228-016-2022-4

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