Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison.

<h4>Background</h4>In recent years, efforts have been made to improve paediatric drug therapy. The aim of this research was to investigate any changes regarding the frequency and nature of adverse drug reactions (ADRs) in hospitalized children in one paediatric general medical ward over...

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Autores principales:	Ann-Kathrin Oehme, Asia N Rashed, Barbara Hefele, Ian C K Wong, Wolfgang Rascher, Antje Neubert
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/09e8eea30c164f2199ff096e55e69546
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spelling	oai:doaj.org-article:09e8eea30c164f2199ff096e55e695462021-11-18T07:05:18ZAdverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison.1932-620310.1371/journal.pone.0044349https://doaj.org/article/09e8eea30c164f2199ff096e55e695462012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23028526/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>In recent years, efforts have been made to improve paediatric drug therapy. The aim of this research was to investigate any changes regarding the frequency and nature of adverse drug reactions (ADRs) in hospitalized children in one paediatric general medical ward over a 9-year period.<h4>Methodology</h4>Two prospective observational cohort studies were conducted at a large University hospital in Germany in 1999 and 2008, respectively. Children aged 0-18 years admitted to the study ward during the study periods were included. ADRs were identified using intensive chart review. Uni- and multivariable regression has been used for data analysis.<h4>Results</h4>A total of 520 patients (574 admissions) were included [1999: n = 144 (167); 2008: n = 376 (407)]. Patients received a total of 2053 drugs [median 3, interquartile range (IQR) 2-5]. 19% of patients did not receive any medication. Median length of stay was 4 days (IQR 3-7; range 1-190 days) with a significantly longer length of stay in 1999. The overall ADR incidence was 13.1% (95% CI, 9.8-16.3) varying significantly between the two study cohorts [1999: 21.9%, 95% CI, 14.7-29.0; 2008: 9.2%, 95% CI, 5.9-12.5 (p<0.001)]. Antibacterials and corticosteroids for systemic use caused most of the ADRs in both cohorts (1999; 2008). Exposure to systemic antibacterials decreased from 62.9% to 43.5% whereas exposure to analgesics and anti-inflammatory drugs increased from 17.4% to 45.2%, respectively. The use of high risk drugs decreased from 75% to 62.2%. In 1999, 45.7% and in 2008 96.2% of ADRs were identified by treating clinicians (p<0.001).<h4>Conclusions</h4>Between 1999 and 2008, the incidence of ADRs decreased significantly. Improved treatment strategies and an increased awareness of ADRs by physicians are most likely to be the cause for this positive development. Nevertheless further research on ADRs particularly in primary care and the establishment of prospective pharmacovigilance systems are still needed.Ann-Kathrin OehmeAsia N RashedBarbara HefeleIan C K WongWolfgang RascherAntje NeubertPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 9, p e44349 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ann-Kathrin Oehme Asia N Rashed Barbara Hefele Ian C K Wong Wolfgang Rascher Antje Neubert Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison.
description	<h4>Background</h4>In recent years, efforts have been made to improve paediatric drug therapy. The aim of this research was to investigate any changes regarding the frequency and nature of adverse drug reactions (ADRs) in hospitalized children in one paediatric general medical ward over a 9-year period.<h4>Methodology</h4>Two prospective observational cohort studies were conducted at a large University hospital in Germany in 1999 and 2008, respectively. Children aged 0-18 years admitted to the study ward during the study periods were included. ADRs were identified using intensive chart review. Uni- and multivariable regression has been used for data analysis.<h4>Results</h4>A total of 520 patients (574 admissions) were included [1999: n = 144 (167); 2008: n = 376 (407)]. Patients received a total of 2053 drugs [median 3, interquartile range (IQR) 2-5]. 19% of patients did not receive any medication. Median length of stay was 4 days (IQR 3-7; range 1-190 days) with a significantly longer length of stay in 1999. The overall ADR incidence was 13.1% (95% CI, 9.8-16.3) varying significantly between the two study cohorts [1999: 21.9%, 95% CI, 14.7-29.0; 2008: 9.2%, 95% CI, 5.9-12.5 (p<0.001)]. Antibacterials and corticosteroids for systemic use caused most of the ADRs in both cohorts (1999; 2008). Exposure to systemic antibacterials decreased from 62.9% to 43.5% whereas exposure to analgesics and anti-inflammatory drugs increased from 17.4% to 45.2%, respectively. The use of high risk drugs decreased from 75% to 62.2%. In 1999, 45.7% and in 2008 96.2% of ADRs were identified by treating clinicians (p<0.001).<h4>Conclusions</h4>Between 1999 and 2008, the incidence of ADRs decreased significantly. Improved treatment strategies and an increased awareness of ADRs by physicians are most likely to be the cause for this positive development. Nevertheless further research on ADRs particularly in primary care and the establishment of prospective pharmacovigilance systems are still needed.
format	article
author	Ann-Kathrin Oehme Asia N Rashed Barbara Hefele Ian C K Wong Wolfgang Rascher Antje Neubert
author_facet	Ann-Kathrin Oehme Asia N Rashed Barbara Hefele Ian C K Wong Wolfgang Rascher Antje Neubert
author_sort	Ann-Kathrin Oehme
title	Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison.
title_short	Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison.
title_full	Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison.
title_fullStr	Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison.
title_full_unstemmed	Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison.
title_sort	adverse drug reactions in hospitalised children in germany are decreasing: results of a nine year cohort-based comparison.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/09e8eea30c164f2199ff096e55e69546
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Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison.

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