Detecting adverse drug reactions to improve patient outcomes

1999 ◽  
Vol 55 (1) ◽  
pp. 61-64 ◽  
Author(s):  
T HANNAN
Keyword(s):  
Patient Outcomes ◽  
Adverse Drug Reactions ◽  
Drug Reactions ◽  
Improve Patient

scholarly journals The Hospital Antimicrobial Use Process: From Beginning to End

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
William R Truong ◽  
Jason Yamaki
Keyword(s):  
Antimicrobial Resistance ◽  
Patient Outcomes ◽  
Adverse Drug Reactions ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Use ◽  
Drug Reactions ◽  
Improve Patient ◽  
Appropriate Antimicrobial Use

Abstract Hospital antimicrobial stewardship (AMS) programs are responsible for ensuring that all antimicrobials are utilized in the most appropriate and safe manner to improve patient outcomes, prevent adverse drug reactions, and prevent the development of antimicrobial resistance. This Perspectives article outlines the hospital antimicrobial use process (AUP), the foundational system that ensures that all antimicrobials are utilized in the most appropriate and safe manner. The AUP consists of the following steps: antimicrobial ordering, order verification, preparation and delivery, administration, monitoring, and discharge prescribing. AMS programs should determine how each step contributes to how an antimicrobial is used appropriately or inappropriately at their institution. Through this understanding, AMS programs can integrate stewardship activities at each step to ensure that every opportunity is taken to optimize antimicrobial use during a patient’s treatment course. Hence, approaching AMS through the framework of a hospital’s AUP is essential to improving appropriate antimicrobial use.

scholarly journals An opportunity for clinical pharmacology trained physicians to improve patient drug safety: A retrospective analysis of adverse drug reactions in teenagers

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 677 ◽  
Author(s):  
Andy R. Eugene ◽  
Beata Eugene
Keyword(s):  
Clinical Pharmacology ◽  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Hospital Admissions ◽  
The United States ◽  
Drug Reactions ◽  
The Third ◽  
Data Limitations ◽  
Ondansetron Hydrochloride ◽  
Improve Patient

Background: Adverse drug reactions (ADRs) are a major cause of hospital admissions, prolonged hospital stays, morbidity, and drug-related mortality. In this study, we sought to identify the most frequently reported medications and associated side effects in adolescent-aged patients in an effort to prioritize clinical pharmacology consultation efforts for hospitals seeking to improve patient safety.   Methods: Quarterly reported data were obtained from the United States Food and Drug Administration Adverse Events Reporting System (FAERS) from the third quarter of 2014 and ending in the third quarter of 2017. We then used the GeneCards database to map the pharmacogenomic biomarkers associated with the most reported FAERS drugs. Data homogenization and statistics analysis were all conducted in R for statistical programming. Results: We identified risperidone (10.64%) as the compound with the most reported ADRs from all reported cases. Males represented 90.1% of reported risperidone cases with gynecomastia being the most reported ADR. Ibuprofen OR=188 (95% CI, 105.00 – 335.00) and quetiapine fumarate OR=116 (95% CI, 48.40 – 278.00) were associated with the highest odds of completed suicide in teenagers. Ondansetron hydrochloride OR=7.12 (95% CI, 1.59 – 31.9) resulted in the highest odds of pneumothorax. Lastly, olanzapine (8.96%) represented the compound with the most reported drug-drug interactions cases, while valproic acid OR=221 (95% CI, 93.900 – 522.00) was associated with the highest odds of drug-drug interactions. Conclusion: Despite any data limitations, physicians prescribing risperidone in males should be aware of the high rates of adverse drug events and an alternative psychotropic should be considered in male patients. Further, patients with a history of pneumothorax or genetically predisposed to pneumothorax should be considered for an alternative antiemetic to ondansetron hydrochloride, due to increased odds associated with the drug and adverse event.

scholarly journals Assessment of adverse drug reactions to antituberculosis regimen in a tertiary care hospital

2019 ◽  
Vol 8 (10) ◽  
pp. 2202
Author(s):  
Sanitha Kuriachan ◽  
Prakash Krishnan ◽  
Bharti Chogtu ◽  
Manu Mathew George
Keyword(s):  
Peripheral Neuropathy ◽  
Adverse Drug Reactions ◽  
Causality Assessment ◽  
Patient Adherence ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Reactions ◽  
Skin Reactions ◽  
Antitubercular Treatment ◽  
Improve Patient

Background: Adverse drug reactions are common with multidrug therapy in tuberculosis, if detected early can improve patient compliance and prevent emergence of resistance.Methods: A prospective observational study as a part of Pharmacovigilance Program under Central Drugs Standard Control Organisation was conducted in Kasturba hospital, Manipal to collect adverse drug reactions (ADR). Data of patients reported with antitubercular treatment (ATT) related ADRs from September 2012 to August 2013 was evaluated for patient demography, type of tuberculosis, ATT regimen, organ/ system affected and time of onset of ADR. ADRs were then subjected to causality assessment as per WHO scale.Results: A total of 65 ADRs were reported in 60 patients during the study period, of which 46.7% were in males and 53.3% in females. 85% of ADRs were reported in patients with pulmonary tuberculosis. 77% of ADRs were observed with daily regimen. Common ADRs were hepatitis (40%), gastritis (15%), skin reactions (15%), peripheral neuropathy (14%), gout (6%) and nephritis (3%). Median duration for the onset of ADR was 31 days each for hepatitis, gout, nephritis and 20, 11, 9 days for gastritis, peripheral neuropathy and skin reactions respectively. As per causality assessment, 80% of ADRs were assigned “possible”, 11% “probable” and 9% “certain”. As per severity scale 27.7% of ADR were severe, 36.9% were moderate.Conclusions: Early detection and management of ADRs is vital for the success of ATT and patient adherence.

Intensive safety monitoring program of antineoplastic medicines: A pilot study in a Portuguese oncology hospital

2019 ◽  
Vol 26 (1) ◽  
pp. 133-140
Author(s):  
Diogo Mendes ◽  
Graça Rigueiro ◽  
Rui S Silva ◽  
Ana Penedones ◽  
Carlos Alves ◽  
...  
Keyword(s):  
Pilot Study ◽  
Adverse Drug Reactions ◽  
Improve Patient Safety ◽  
Monitoring Program ◽  
Safety Monitoring ◽  
Prescription Data ◽  
Trastuzumab Emtansine ◽  
Drug Reactions ◽  
Number Of Patients ◽  
Improve Patient

Purpose The aim of this study was to test the feasibility and the usefulness of an intensive safety monitoring program to identify adverse drug reactions for medicines under additional monitoring that are used to treat cancer patients within a Portuguese oncology hospital. Methods This pilot intensive safety monitoring program was a three-month prospective, observational study. Patients undergoing treatment with one of the following medicines were included: nivolumab, olaparib, palbociclib, pembrolizumab, pertuzumab, ramucirumab, ribociclib, trastuzumab emtansine, or trifluridine/tipiracil. Potential eligible patients were identified by pharmacists based on prescription data. Clinicians used proper paper-based reporting forms to record adverse drug reactions. Clinical secretariats sent those reports through an electronic platform to the pharmacovigilance department for analysis. Results Seventy-five patients were on treatment with selected medicines. Of those, 33 (44%) experienced adverse drug reactions: 23 (69.7%) cases were serious and 5 (15.2%) unexpected. Considering the number of patients exposed to each medicine and the number of patients experiencing adverse drug reactions, trifluridine/tipiracil (72.7%; 8/11) was associated with the highest rate of toxicity, followed by olaparib (66.7%; 2/3), trastuzumab emtansine (50.0%; 3/6), pertuzumab (47.8%; 11/23), pembrolizumab (45.5%; 5/11), palbociclib (25.0%; 1/4), and nivolumab (18.8%; 3/16). A total of 59 adverse drug reactions were identified (i.e. 1.8 adverse drug reactions/patient), mainly gastrointestinal disorders ( n = 15; 25.4%), and blood and lymphatic system disorders ( n = 14; 23.7%). Conclusion This intensive safety monitoring program was feasible and allowed identifying serious and unexpected adverse drug reactions, adding value to pharmacovigilance and therefore contributing to improve patient safety. Further research is needed to confirm the findings of this pilot study.

scholarly journals Choosing medications wisely: Is it time to address paediatric polypharmacy?

2019 ◽  
Vol 24 (5) ◽  
pp. 303-305
Author(s):  
Orly Bogler ◽  
Daniel Roth ◽  
James Feinstein ◽  
Marina Strzelecki ◽  
Winnie Seto ◽  
...  
Keyword(s):  
Best Practices ◽  
Patient Outcomes ◽  
Adverse Drug Events ◽  
Youth Mental Health ◽  
Medical Community ◽  
Drug Reactions ◽  
Medical Treatments ◽  
Off Label ◽  
Paediatric Prescribing ◽  
Improve Patient

Abstract There is a growing focus in the medical community on de-escalating medical treatments where appropriate; however, specific efforts to reduce medication burden in patients with polypharmacy has largely been targeted toward adult populations. Polypharmacy increases the risk of adverse drug reactions in children, and that risk may be further increased by the use of off-label drugs. The paediatric prescribing community should explore pharmacovigilance strategies and deprescription initiatives that prioritize patients with polypharmacy. Currently, best practices may be extrapolated from the adult literature, including medication review algorithms and patient education tools. Enhancing access to nonpharmacological modalities to address child and youth mental health may mitigate psychotropic polypharmacy. The aim of these initiatives should be to improve patient outcomes and experiences by avoiding adverse drug events and drug–drug interactions.

scholarly journals Novel Insights into Data Mining to Improve the Specificity of Pharmacovigilance and Prevent Adverse Drug Reactions in Psychiatric Patients

2021 ◽  
Vol 16 (3) ◽  
pp. 130-136
Author(s):  
Aarushi Jain ◽  
Arunava Ghosh
Keyword(s):  
Data Mining ◽  
Patient Outcomes ◽  
Adverse Drug Reactions ◽  
Psychiatric Patients ◽  
Drug Reactions ◽  
Research Gaps ◽  
Healthcare Data ◽  
Hospitalization Costs ◽  
Clinical Data Mining ◽  
Novel Applications

The aim of this perspective is to provide a review upon the fundamental computational methods deployed in data mining as applied to healthcare data, with particular regards to patient records of psychiatric patients. Albeit clinical data mining has advanced over the years, further research is needed to improve the specificity of pharmacovigilance and prevent adverse drug reactions in psychiatric patients. From describing the main principles and present challenges of data mining to its most-novel applications in clinical psychiatry, this literature review highlights current research gaps that have to be filled to increase the efficacy of psychiatric drugs nowadays, thus improving patient outcomes and decreasing hospitalization costs.

scholarly journals An opportunity for clinical pharmacology trained physicians to improve patient drug safety: A retrospective analysis of adverse drug reactions in teenagers

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 677
Author(s):  
Andy R. Eugene ◽  
Beata Eugene
Keyword(s):  
Clinical Pharmacology ◽  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Hospital Admissions ◽  
The United States ◽  
Drug Reactions ◽  
The Third ◽  
Data Limitations ◽  
Ondansetron Hydrochloride ◽  
Improve Patient

Background: Adverse drug reactions (ADRs) are a major cause of hospital admissions, prolonged hospital stays, morbidity, and drug-related mortality. In this study, we sought to identify the most frequently reported medications and associated side effects in adolescent-aged patients in an effort to prioritize clinical pharmacology consultation efforts for hospitals seeking to improve patient safety.   Methods: Quarterly reported data were obtained from the United States Food and Drug Administration Adverse Events Reporting System (FAERS) from the third quarter of 2014 and ending in the third quarter of 2017. We then used the GeneCards database to map the pharmacogenomic biomarkers associated with the most reported FAERS drugs. Data homogenization and statistics analysis were all conducted in R for statistical programming. Results: We identified risperidone (10.64%) as the compound with the most reported ADRs from all reported cases. Males represented 90.1% of reported risperidone cases with gynecomastia being the most reported ADR. Ibuprofen OR=188 (95% CI, 105.0000 – 335.000) and quetiapine fumarate OR=116 (95% CI, 48.4000 – 278.000) were associated with the highest odds of completed suicide in teenagers. Ondansetron hydrochloride OR=7.12 (95% CI, 1.59 – 31.9) resulted in the highest odds of pneumothorax. Lastly, olanzapine (8.96%) represented the compound with the most reported drug-drug interactions cases, while valproic acid OR=221 (95% CI, 93.9000 – 522.000) was associated with the highest odds of drug-drug interactions. Conclusion: Despite any data limitations, physicians prescribing risperidone in males should be aware of the high rates of adverse drug events and an alternative psychotropic should be considered in male patients. Further, patients with a history of pneumothorax or genetically predisposed to pneumothorax should be considered for an alternative antiemetic to ondansetron hydrochloride, due to increased odds associated with the drug and adverse event.

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