Personalising drug safety—results from the multi-centre prospective observational study on Adverse Drug Reactions in Emergency Departments (ADRED)

Just KS, Dormann H, Böhme M, Schurig M, Schneider KL, Steffens M, Dunow S, Plank-Kiegele B, Ettrich K, Seufferlein T, Gräff I, Igel S, Schricker S, Jaeger SU, Schwab M, Stingl JC (2020)

Publication Type: Journal article

Publication year: 2020

Journal

European Journal of Clinical Pharmacology Springer Verlag (Germany)

Book Volume: 76

Pages Range: 439-448

Journal Issue: 3

DOI: 10.1007/s00228-019-02797-9

Abstract

Purpose: Adverse drug reactions (ADR) account for 5 to 7% of emergency department (ED) consultations. We aimed to assess medication risk profiles for ADRs leading to ED visits. Methods: We analysed medication intake and patient demographics in a prospective multi-centre observational study collecting ADR cases in four large EDs in Germany. Odds ratios (OR) were calculated to relate drug classes taken to those suspicious for an ADR after a causality assessment. Results: A total of 2215 cases of ED visits due to ADRs were collected. The median age of the cohort was 73 years; in median, six co-morbidities and an intake of seven drugs were documented. Antineoplastic/immunomodulating agents had the highest OR for being suspected for an ADR (OR 20.45, 95% CI 14.54–28.77), followed by antithrombotics (OR 2.94, 95% CI 2.49–3.47), antibiotics (OR 2.65, 95% CI 1.78–3.95), systemic glucocorticoids (OR 2.43, 95% CI 1.54–3.82) and drugs affecting the central nervous system (CNS), such as antipsychotics (OR 2.36, 95% CI 1.46–3.81), antidepressants (OR 2.10, 95% CI 1.57–2.83), antiparkinsonian medication (OR 2.11, 95% CI 1.15–3.84), opioids (OR 1.79, 95% CI 1.26–2.54) and non-opioid analgesics (OR 1.32, 95% CI 1.01–1.72). Conclusions: Patients experiencing ADRs leading to ED visits are commonly old, multi-morbid and multi-medicated. CNS drugs may be more relevant than prior expected. With calculating ORs, we could replicate involvement of antineoplastic agents, antithrombotics, antibiotics, systemic glucocorticoids and non-opioid analgesics as frequently suspected for ADRs in EDs. Trial registration: DRKS-ID: DRKS00008979.

Involved external institutions

Universitätsklinikum Aachen (UKA) DE Germany (DE) Klinikum Fürth DE Germany (DE) Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) / Federal Institute for Drugs and Medical Devices DE Germany (DE) Universitätsklinikum Ulm DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE) Dr. Margarete Fischer-Bosch-Institut für Klinische Pharmakologie DE Germany (DE) Robert-Bosch-Krankenhaus DE Germany (DE)

How to cite

APA:

Just, K.S., Dormann, H., Böhme, M., Schurig, M., Schneider, K.L., Steffens, M.,... Stingl, J.C. (2020). Personalising drug safety—results from the multi-centre prospective observational study on Adverse Drug Reactions in Emergency Departments (ADRED). European Journal of Clinical Pharmacology, 76(3), 439-448. https://doi.org/10.1007/s00228-019-02797-9

MLA:

Just, Katja S., et al. "Personalising drug safety—results from the multi-centre prospective observational study on Adverse Drug Reactions in Emergency Departments (ADRED)." European Journal of Clinical Pharmacology 76.3 (2020): 439-448.

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