PREVALENCE AND ASSESSMENT OF FACTORS CONTRIBUTING TO ADVERSE DRUG REACTIONS IN WARDS OF A TERTIARY CARE HOSPITAL, INDIA

Abstract

BACKGROUND: Adverse drug reactions account for the highest proportion among the causes ofmorbidity and mortality in clinical wards and are posing a considerable challenge. Hence, the objectiveof this study was to find out the prevalence of adverse drug reactions and the factors which contribute totheir prevalence.METHODS: A prospective patient record review was carried out at a tertiary care hospital in North Indiafrom August 2010- May 2011. A total of 1033 subjects admitted to hospital for any kind of treatment wereincluded while patients admitted in the ward because of adverse drug reactions were excluded. The wardwhere we collected the data includes multispecialty and cardiovascular wards. The causality, severity,and preventability of adverse drug reactions were assessed using Naranjo, modified Hartwig, andSchumock and Thornton criteria, respectively. Kolmogorov–Smyrnov, chi –square and multiple logisticregression tests were used to determine adverse drug reactions ascribed to drugs.RESULTS: Out of 1033 patients whose records were assessed, 167(16.2%) experienced one or moreadverse drug reactions. The metabolic systems, which accounted for 49(24.6%) were most frequentlyaffected by adverse drug reactions, followed by gastrointestinal, 45(22.6%); hematological, 28(14.1%)and cutaneous, 21(10.6%) systems. The drug classes most frequently associated with the reactions wereantibiotics 40(20.1%), diuretics 35(17.6%) and anticoagulants 30(15.1%). According to the selectedpreventability scale, 72(36.2%) adverse drug reactions were classified as probably or definitelypreventable. About 165(83%) of the reactions were type A, which represents augmentation of thepharmacological action of a drug. Number of drugs, length of hospitalization and number of diagnosiswere identified as significant predisposing factors for ADRs.CONCLUSION: The result of this study suggested that adverse drug reactions were significant causes ofsuperimposed health problems that occur following hospitalization. The major risk factors associatedwith ADR include number of drugs, length of hospitalization and number of diagnosis. Based on thefindings a rigorous study is recommended to determine the burden and identify the risk factors of adversedrug reactions to target interventions.