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Regional surveillance of emergency-department visits for outpatient adverse drug events

  • Pharmacoepidemiology and Prescription
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Abstract

Aims

To determine the (1) incidence of adverse drug events (ADEs) in 10 emergency department (EDs) of general hospitals in the Regione Campania (southern Italy), (2) rate of ADE-related hospital admissions, (3) drug classes most frequently involved, and (4) the types of ADEs and their frequency.

Methods

We performed a cohort study of all patients attending the EDs. This study was carried out in two observational periods of 10 days each in 10 EDs. Demographic, clinical, and pharmacological data about all patients admitted to EDs were collected by trained and qualified monitors. Records related to ADEs were analyzed and validated by a specific scientific committee.

Results

Of 7,861 ED visits, 96 were ADE-related. The incidence of hospitalization was higher in patients who had taken medication than in patients with a negative drug history (24.9 vs. 16.4%). ADEs were significantly more frequent in women. Patients aged between 60 and 69 years and between 30 and 39 years were significantly more likely to experience an ADE. Serious ADEs were identified in 20 ED visits (20.8% of total sample). Antibiotics, NSAIDs, and agents acting on the renin-angiotensin system were the drugs most often involved in ADEs. In multivariate analyses, the adjusted odds ratio was 3.4 (95% CI: 1.07–2.84) for patients taking NSAIDs, 4.78 (95% CI: 2.26–10.12) for those taking β2-adrenergic-receptor agonists, and 6.20 (95%CI: 2.74–14.06) for those taking β-lactam antibiotics.

Conclusion

This study shows that ADEs are an important problem in industrialized countries. Moreover, it shows that ADEs affect hospital admission rates and reinforces the importance of drug-induced disease as a public health problem.

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Acknowledgements

The authors thank the monitors for data collection and the physicians of the 10 hospital EDs involved in the study: Azienda Ospedaliera (A.O.) A Cardarelli, Napoli, A.O. S. Maria degli Incurabili di Napoli, Presidio Ospedaliero (P.O) Loreto Mare di Napoli, A.O. Pellegrini di Napoli, A.O. San Paolo di Napoli, A.O. San Giuseppe Moscati di Avellino, A.O. G. Rummo di Benevento, A.O. San Sebastiano di Caserta, AA.OO.RR. San Giovanni di Dio e Ruggi d’Aragona di Salerno, and Ospedale San Leonardo di Castellammare di Stabia. We are grateful to Jean Ann Gilder for text editing. This study was supported by grants from Regione Campania (Delibera Giunta Regionale no. 6458 del 31/11/2001).

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Authors and Affiliations

  1. Department of Experimental Medicine, Section of Pharmacology Leonardo Donatelli, Center of Pharmacosurveillance and Pharmacoepidemiology, Faculty of Medicine and Surgery, Second University of Naples, Naples, Italy

    A. Capuano, M. Gallo, L. Ferrante, M. L. Illiano, B. Rinaldi, A. Filippelli & F. Rossi

  2. Department of European and Mediterranean Studies, Faculty of Political Studies and Higher European Education Jean Monnet, Second University of Naples, Naples, Italy

    A. Irpino

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  1. A. Capuano
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  2. A. Irpino
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  3. M. Gallo
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  4. L. Ferrante
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  5. M. L. Illiano
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  6. B. Rinaldi
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  7. A. Filippelli
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  8. F. Rossi
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Correspondence to A. Capuano.

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Capuano, A., Irpino, A., Gallo, M. et al. Regional surveillance of emergency-department visits for outpatient adverse drug events. Eur J Clin Pharmacol 65, 721–728 (2009). https://doi.org/10.1007/s00228-009-0641-8

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  • DOI: https://doi.org/10.1007/s00228-009-0641-8

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