Evaluation of Potentially Inappropriate Medication Use and Risk of Adverse Drug Reactions in Hospitalized Older Adults: An Observational Study in a Tertiary Care Hospital

Background: An adverse drug reaction (ADRs) is determined as response to a drug that is noxious unintended excludes therapeutic failures, overdose, drug abuse, noncompliance, and medication errors. The main aim of the study is to detect, understand and report ADR’S.Methods: This study is prospective observational study conducted for 6 months in in-patient setting in a tertiary care hospital. Naranjo’s, WHO causality scale, Siegel scale, Schumock and Thornton scale are used to assess ADR. Graph Pad Prism and SAS software’s are used.Results: Data was collected from a total of 1000 patients of which 121 (12.1%) patients were effected with 150 ADRs. Among 121 patients AdrAd was 60.66% and AdrIn was 39.33%. Of 121 patients 97 patients with single ADR, 28 patients with 2 ADRs, 10 patients were with three ADRs. ADR onset divides acute (10%), Latent (39%) and sub-acute (51%). ADR occurred are recovered (54%), Recovering (13%). Naranjos scale interprets definite (0.9%), probable (50.9%), possible (42.97%). According to WHO scale certain (2.7%), unlikely (2.7%), possible (38.84%). Hartwig and Siegel scale results are mild (12.4%), moderate (66.12%) and severe (12.4%). Schumock and Thornton preventability results are definitely (25.45%), probably (68.18%) and not preventable (6.36%).Conclusions: Every health care professional should be aware of the Pharmacovigilance principles and also should be aware of suspected ADR reporting form of PVPI. By applying the above scales it is easy for health care professionals to assess an ADR.

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An observational study to analyze predisposing factors, causality, severity and preventability of adverse drug reactions among multidrug resistant tuberculosis patients treated under RNTCP program in Northern India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20190918 ◽

2019 ◽

Vol 7 (3) ◽

pp. 687

Author(s):

Preet Lakhani ◽

Divya Singh ◽

Shireen Barua ◽

Suchi Jain ◽

Surya Kant ◽

...

Keyword(s):

Observational Study ◽

Causality Assessment ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Multidrug Resistant ◽

Predisposing Factors ◽

Care Hospital ◽

Drug Reactions ◽

Resistant Tuberculosis ◽

Previously Treated

Background: There were 4.1% of all new cases and 19% of previously treated patients were diagnosed with either multidrug resistant or rifampicin resistant tuberculosis in 2016. In the state of Uttar Pradesh, there were 2.16 new cases and 44,531 previously treated cases. The objectives of the study were to assess the predisposing factors, causality assessment, severity grading and avoidability of the adverse drug reactions (ADRs) of the antitubercular drugs in MDR-TB patients in a tertiary care hospital of northern India.Methods: This prospective observational study was conducted for 12 months at a tertiary care hospital. The patients with MDR tuberculosis on treatment with DOTS Plus regimen under RNTCP and who met the inclusion exclusion criteria were recruited after informed consent. ADRs were monitored daily till the patients remained admitted and thereafter monthly. Predisposing factors were recorded. Causality assessment was performed by Naranjo scale and WHO UMC scale, severity by Hartwig’s scale and avoidability by Halla’s scale.Results: There were 115 patients were recruited, 70 developed at least one ADR. 98 ADRs were reported. The commonest ADR reported were – gastrointestinal (38.76%), neurological (21.24%) and hepatobiliary (8.16%). Diabetes and HIV predisposed to development of ADRs. 58.18% ADRs were classified as possible and 37.5% as probable by Naranjo’s scale. 51.02% ADRs were classified as probable and 42.83% as possible by WHO-UMC. 56% were classified as mild, 36% moderate, and 6% severe via Hartwig’s scale. 51 ADRs were classified as avoidable and 40 ADRs were possibly avoidable.Conclusions: Monitoring and assessment of ADRs is necessary to promote awareness, curb resistance and maintain adherence.

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An Observational Study to Evaluate the Adverse Drug Reactions Secondary to the Use of Anti-Microbial Agents in Patients Admitted to Surgery Ward at Tertiary Care Hospital

SSRN Electronic Journal ◽

10.2139/ssrn.3377856 ◽

2019 ◽

Author(s):

Sumit Kumar ◽

Bhagya Sattigeri

Keyword(s):

Observational Study ◽

Adverse Drug Reactions ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Drug Reactions ◽

Microbial Agents

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An Observational Study to Analyze the Adverse Drug Reactions Among the Elderly at a Tertiary Care Hospital

Biomedical & Pharmacology Journal ◽

10.13005/bpj/1115 ◽

2017 ◽

Vol 10 (1) ◽

pp. 345-352 ◽

Cited By ~ 1

Author(s):

C. R. Jayanthi ◽

M. Renuka ◽

P. Panchaksharimath

Keyword(s):

Observational Study ◽

Adverse Drug Reactions ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

The Elderly ◽

Care Hospital ◽

Drug Reactions

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PRESCRIPTION ANALYSIS AND PREVALENCE OF POTENTIALLY INAPPROPRIATE MEDICATION USE IN OLDER ADULTS; AN OBSERVATIONAL STUDY

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2020v12i2.36209 ◽

2020 ◽

pp. 108-112

Author(s):

N. SENTHIL KUMAR ◽

GEENA K. REJI ◽

REEMA K. A. ◽

VIJAYARANGAN S. ◽

RAMYA A.

Keyword(s):

Older Adults ◽

Observational Study ◽

Adverse Drug Reactions ◽

Inappropriate Medication ◽

Tertiary Care ◽

Potentially Inappropriate Medications ◽

Drug Reactions ◽

Geriatric Population ◽

Institutional Ethics ◽

Inappropriate Medications

Objective: The objectives of the present study were to determine the prevalence of Potentially Inappropriate Medications and Adverse Drug Reactions in older adults and to collect doctors’ responses regarding the PIM list or any other criteria to treat older adults in India. Methods: This was an observational study conducted in different tertiary care hospitals of two districts, Erode and Salem after obtaining approval of the Institutional Ethics Committee. A sample of 250 older adults (60 y and above) and 97 doctors were included during the study period of 6 mo from February 2019 to July 2019. Inappropriate medications were identified by using 2019 updated Beer’s criteria. The causality of the adverse events was assessed by Naranjo Adverse Drug Reaction Probability Scale. Results: Out of the 250 prescriptions, only 86(34.4%) of the prescriptions were appropriate and 164(65.6%) were inappropriate. The most commonly inappropriate prescribed medications were diuretics, ranitidine, and tramadol. A total of 74 ADRs was observed in 74 patients. Of these, 57(22.8%) ADRs were due to inappropriate medications listed in Beers criteria. There was a significant association between the occurrence of ADRs and the use of PIMs listed in 2019 updated Beer’s criteria [χ2 = 6.08, P = 0.013 (df = 1)]. Conclusion: The study shows that there is a high prevalence of inappropriate medications and adverse drug reactions in hospitalized older adults. Beer’s criteria can be used as a guideline by the physicians while prescribing the drugs to the geriatric population.

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Inappropriate medication use among hospitalized older adults in Italy: results from the Italian Group of Pharmacoepidemiology in the Elderly

European Journal of Clinical Pharmacology ◽

10.1007/s00228-003-0600-8 ◽

2003 ◽

Vol 59 (2) ◽

pp. 157-162 ◽

Cited By ~ 88

Author(s):

Graziano Onder ◽

◽

Francesco Landi ◽

Matteo Cesari ◽

Giovanni Gambassi ◽

...

Keyword(s):

Older Adults ◽

Inappropriate Medication ◽

Medication Use ◽

The Elderly ◽

Inappropriate Medication Use ◽

Hospitalized Older Adults

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Medication errors and adverse drug reactions in psychiatry department: A prospective observational study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4538 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 2669-2674

Author(s):

Dona Thomas ◽

Sharon Thomas ◽

Venkateswaramurthy N ◽

Sambathkumar R

Keyword(s):

Observational Study ◽

Medication Errors ◽

Adverse Drug Reactions ◽

Tamil Nadu ◽

Prospective Observational Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Drug Reactions ◽

Psychiatry Department

The study was aimed to analyse the pattern of medication errors and drug interaction induced adverse drug reactions in the psychiatry department of a tertiary care hospital. A Prospective observational study being conducted in the inpatient and outpatient department of psychiatry in a tertiary care hospital, Erode, Tamil Nadu for over six months. A total of 80 prescriptions with psychiatric illness and 174 medication errors were observed. Of the 174 medication errors observed, 132(75.8%) were incomplete prescriptions making the highest number of medication errors. The highest number of errors occurred due to Prescription error 156(89.0%), followed by administration error 8(4.5%). According to the NCCMERP classification, the majority of medication errors were coming under category B 120(68.9%) but there is no harm. The demographic reports of outpatients in the present study showed a higher incidence of medication errors in patients with the age group of 31-40 years 25(36.7%). Considering the factors contributing to a medication error, refusal of the patient to take the drug 27(39.7%) followed by forgetting 13(19.1%) due to the vulnerable characteristics of the patient was more significant. Although there is a general lack of awareness, many patients and bystanders are unaware of their diagnosis and medications. It is, therefore, a crucial step to educate and make them aware of the correct use of medicine.

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