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Detection of Adverse Drug Reactions in a Neurological Department

Comparison Between Intensified Surveillance and a Computer-Assisted Approach

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Abstract

Objectives: Adverse drug reactions (ADRs) leading to hospitalisation or occurring during hospital stay contribute significantly to patient morbidity and mortality as well as representing an additional cost for healthcare systems. The aim of this study was to provide data about the type and incidence of ADRs in a neurological department and to compare two different methodological approaches to collecting information on ADRs.

Methods: The two methods used were intensified surveillance of neurological wards by daily ward rounds and computer-assisted screening for ADRs by means of pathological laboratory parameters.

Results: Of admissions to the neurological department, 2.7% were caused by an ADR and 18.7% of patients experienced at least one ADR during hospitalisation. The positive predictive values of pathological laboratory parameters ranged between 0% (eosinophil count) and 100% for increased drug serum concentrations and international normalised ratio, i.e. the latter were always accompanied by a clinically relevant ADR. However, only half of all ADR could be detected by pathological laboratory parameters, the sensitivity of this method came to 45.1% with a specificity of 78.9%.

Conclusion: Similar to departments of internal medicine, a high number of ADRs occur on neurological wards. The predominant ADRs were those typical of neurotropic medications such as dyskinesia and increased sedation. Due to the age of the patients involved, cardiovascular co-medication is often prescribed and represents an additional risk factor for ADRs. By measuring pathological laboratory parameters the majority of ADRs could not be detected in neurological patients.

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Acknowledgements

We are indebted to all physicians and nurses in the department of neurology during our data collection period and especially Professor Joerg, MD for his continuous advice. We also thank S. Pasche for his technical assistance and Dr C. Zwernemann for his support in data collection.

No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the contents of this manuscript.

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Authors and Affiliations

  1. Philipp Klee-Institute of Clinical Pharmacology, Hospital Wuppertal GmbH, University of Witten/Herdecke, Heusnerstr. 40, Wuppertal, 42283, Germany

    Petra A. Thuermann, Roland Windecker, Joachim Steffen, Markus Schaefer, Ute Tenter, Erich Reese & Klaus Schmitt

  2. Department of Neurology and Neurophysiology, Hospital Wuppertal GmbH, University of Witten/Herdecke, Wuppertal, Germany

    Hermann Menger

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  1. Petra A. Thuermann
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Correspondence to Petra A. Thuermann.

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Thuermann, P.A., Windecker, R., Steffen, J. et al. Detection of Adverse Drug Reactions in a Neurological Department. Drug-Safety 25, 713–724 (2002). https://doi.org/10.2165/00002018-200225100-00004

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