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首页> 外文期刊>Journal of Clinical Sciences >Economic burden, impact, and consequence of adverse drug reactions among medical inpatients in clinical practice
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Economic burden, impact, and consequence of adverse drug reactions among medical inpatients in clinical practice

机译：临床实践中医学住院患者的经济负担，影响和药物不良反应的后果

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Background: An adverse drug reaction (ADR) is defined in this study as a response to a drug which is noxious and unintended that occurs at doses normally used for therapeutic purposes. Despite the extensive study and attention given to ADRs, they still represent a clinically significant problem and burden with high prevalence. Aim: The main aim of this study was to adequately evaluate the economic burden, impact, and consequence of ADRs among adult medical inpatients in clinical practice, to highlight the pattern of medications most frequently involved in ADRs, and to estimate the economic cost implication of treating ADRs in such clinical practice setting. Methods: The patients admitted into the adult medical wards of a Nigerian university teaching hospital over a 9-month period from December 2013 to August 2014 were prospectively recruited for the study and followed up till discharge. Results: Five hundred and seven patients were evaluated during the study, out of which 269 (53.1%) of them were male and 238 (46.9%) were female. The mean age of the study population was 48.9 ± 17.8 years (median: 46 years). Most ADRs were mild and moderate in 21 (41.2%) cases and 24 (47.1%) cases, respectively. Severe ADRs occurred in 2 (3.9%) cases, while four (7.8%) cases were fatal ADRs. The economic cost implication of treating ADRs was ? 161,668.00 ($1243.60), equivalent to about 1.9% of the total cost of all medications used by all admitted medical inpatients during admission. The cost of treating ADRs per patient with ADRs was ? 3169.96 ± ? 6348.77 ($24.38 ± $48.84), while the mean ADR treatment cost per admitted medical inpatient was ? 318.87 ($2.45). The most frequently affected body systems by ADRs were the central nervous system and the gastrointestinal system corresponding to the antidiabetic drug – insulin use causing neuroglycopenic symptoms and nonsteroidal anti-inflammatory drugs (NSAIDs) use causing NSAID-induced gastroenteritis/GIT bleeding, respectively. Conclusions: The economic burden, impact, and consequence of ADRs were significantly high among these adult medical inpatients. In this study, ADRs increase patients' morbidity, mortality, cost of health care, and length (duration) of hospitalization. Insulin and NSAIDs caused the highest number of ADRs which indicate that adequate caution, proper care, and continuous monitoring must be implemented during the course of treating patients with these drugs to optimize their clinical efficacy and prevent the occurrence of ADRs in them.
机译：背景：本研究将药物不良反应（ADR）定义为对有毒和非预期药物的反应，该反应以通常用于治疗目的的剂量发生。尽管对ADR进行了广泛的研究和关注，但它们仍然代表着临床上的重大问题和高负担。目的：本研究的主要目的是在临床实践中充分评估成人医疗住院患者中ADR的经济负担，影响和后果，突出显示最常参与ADR的药物模式，并估算ADR的经济成本含义。在这样的临床实践环境中治疗ADR。方法：从2013年12月至2014年8月的9个月内，从尼日利亚大学教学医院的成人医学病房收治的患者被纳入研究对象，并随访直至出院。结果：研究期间对570例患者进行了评估，其中男性269例（53.1％），女性238例（46.9％）。研究人群的平均年龄为48.9±17.8岁（中位数：46岁）。大多数ADR分别为轻度和中度，分别为21（41.2％）和24（47.1％）例。严重ADR发生2例（3.9％），而致命ADR发生4例（7.8％）。治疗ADR的经济成本为？ 161,668.00（$ 1243.60），约占所有住院的住院患者使用的所有药物总费用的1.9％。每位ADR患者治疗ADR的费用为？ 3169.96±？ 6348.77（$ 24.38±$ 48.84），而平均每名住院患者的ADR治疗费用为？ 318.87（$ 2.45）。 ADR影响最频繁的身体系统是中枢神经系统和胃肠道系统，分别对应于抗糖尿病药物-使用胰岛素会引起神经糖原性症状和使用非甾体抗炎药（NSAIDs）分别引起NSAID引起的胃肠炎/ GIT出血。结论：在这些成年内科住院病人中，ADR的经济负担，影响和后果显着较高。在这项研究中，ADR会增加患者的发病率，死亡率，医疗保健成本以及住院时间（持续时间）。胰岛素和非甾体抗炎药引起的ADR数量最多，这表明在用这些药物治疗患者的过程中必须进行充分的谨慎，适当的护理和连续的监测，以优化其临床疗效并防止其中发生ADR。

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