Adverse drug reaction reporting in a tertiary care teaching hospital in eastern India: a retrospective study
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20194280Keywords:
ADRs, Causality, Preventability, Retrospective study, SeverityAbstract
Background: Adverse drug reactions (ADRs) are one of the prime causes of morbidity and mortality, increase in hospital stay and socioeconomic burden on the patients. Periodic monitoring aids in formulating methods for safe usage of medicines in hospitals. This study was undertaken to study the patterns, assessment of causality, severity, preventability, body systems affected from ADRs received by the Pharmacovigilance cell, Department of Pharmacology between April 2018 to June 2019.
Methods: The present study is an observational, retrospective, non-interventional analysis of voluntarily reported ADRs. Demography of patients, causative drugs, reactions, outcome, and severity are recorded. Data were analysed and expressed in numbers, percentages.
Results: A total of 180 ADRs were spontaneously reported. Dermatology (42.8%), psychiatry (23.9%) and general medicine (18.3%) are the major departments reporting ADRs in our hospital. 60.6% reports were in males. The body system with maximum reactions is dermatological (51.1%). Drug class most commonly affected is anti-microbials (36.1%). Paracetamol (8.9%) is the most common drug with reactions. Causality assessment stated that 41.7% ADRs are probable and 58.3% were possible. Severity assessment showed 86.7% as mild and 13.3% as moderate. Preventability assessment stated that 93.3% ADRs not preventable, 5.6% probably preventable and 1.1% definitely preventable.
Conclusions: The study provides a valuable insight with regards to the pattern of ADRs in our hospital. This will be useful in initiating a reporting culture, increase awareness, reducing under-reporting of ADR in our set up.
References
Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: A meta-analysis of prospective studies. JAMA. 1998;279:1200-5.
Patel TK, Patel PB. Incidence of adverse drug reactions in Indian hospitals. A systematic review of prospective studies. Curr Drug Saf. 2016;11(2):128-36.
Sultana J, Cutroneo P, Trifiro G. Clinical and economic burden of adverse drug reactions. J Pharmacol Pharmacother. 2013;4(1):73-7.
International drug monitoring: the role of national centres. Report of a WHO meeting. World Health Organ Tech Rep Ser. 1972;498:1-25.
Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356(9237):1255-9.
Gallelli L, Ferreri G, Colosimo M, Pirritano D, Flocco MA, Pelaia G, et al. Retrospective analysis of adverse drug reactions to bronchodilators observed in two pulmonary divisions of Catanzaro, Italy. Pharmacol Res. 2003;47(6):493-9.
Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239-45.
Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm. 1992;49:2229-32.
Schumock GT, Thornton JP. Focusing on the preventability of adverse drug reactions. Hosp Pharm. 1992;27:538.
Rawlins MD, Thompson JW. Pathogenesis of adverse drug reactions. In: Davies DM, ed. Textbook of adverse drug reactions. 10th ed. Oxford: Oxford University Press; 1977: 27.
Ramesh M, Pandit S, Parthsarathi G. Adverse drug reactions in a South Indian hospital-their severity and cost involved. Pharmacoepidemiol Drug Saf. 2003;12:687-92.
Backstorm M, Mjorndal T, Dahlquist R. Underreporting of serious adverse drug reactions. Sweden Pharmacoepidemiol Drug Saf. 2004;13:483-7.
American Society of Health System Pharmacists. ASHP guidelines on adverse drug reaction monitoring and reporting. Am J Hosp Pharm. 1989;46:336-7.
Jose J, Rao PGM. Pattern of adverse drug reactions notified by spontaneous reporting in an Indian tertiary care teaching hospital. Pharmacol Res. 2006;54:226-33.
Singh P, Agrawal M, Hishikar R, Joshi U, Maheshwari B, Halwai A. Adverse drug reactions at adverse drug reaction monitoring center in Raipur: analysis of spontaneous reports during 1 year. Indian J Pharmacol. 2017;49:432-7.
Pathak AK, Kumar M, Dokania S, Mohan L, Dikshit H. A Retrospective analysis of reporting of adverse drug reactions in a tertiary care teaching hospital: one-year survey. J Clin Diagnos Res. 2016;10(8):1-4.
Arulmani R, Rajendran SD, Suresh B. Adverse drug reaction monitoring in a secondary care hospital in South India. Br J Clin Pharmacol. 2007;65(2):210-6.
Bhattacharjee P, Das L, Ghosh R, Lalromawii, Das UK. Pattern of adverse drug reactions reported at a tertiary health care teaching hospital of Tripura: a retrospective study. Int J Basic Clin Pharmacol. 2016;5:1293-9.
Gupta A, Kaur A, Shukla P, Chhabra H. Adverse drug reactions pattern in a tertiary level teaching hospital: a retrospective study. Indian J Pharm Practice. 2017;10(1):27-31.
Patidar D, Rajput MS, Nirmal NP, Savitri W. Implementation and evaluation of adverse drug reaction monitoring system in a tertiary care teaching hospital in Mumbai, India. Interdisciplinar Toxicol. 2013;6(1):41-6.
Sharma R, Dogra D, Dogra N. A study of cutaneous adverse drug reactions at a tertiary centre in Jammu, India. Indian Dermatol Online J. 2015;6(3):168-71.
Roy K, Divya S, Nadig P, Prakash B. Monitoring and analysis of adverse drug reactions in a private tertiary care teaching hospital. Asian J Pharmaceut Clin Res. 2015;8(2):335-7.
Jayanthi CR, Darshini MB. A study to analyze the pattern, causality, severity, predictability, and preventability of adverse drug reactions among patients attending the department of obstetrics and gynecology at a tertiary care hospital. Natl J Physiol Pharm Pharmacol. 2019;9(2):172-7.