Drug-related visits to the medical emergency department: a prospective study from India.
OBJECTIVE
To analyze the contribution of adverse drug events (ADEs) to the overall number of visits to the medical emergency and to determine the proportion of events leading to hospital admissions.


METHODS
All visits to the medical emergency were recorded in a prospective, non-interventional design study over a period of 8 months. The ADEs were divided into 5 categories: adverse drug reactions (ADRs), drug interactions, patient non-compliance, physician non-compliance, and drug overdose. The cases were then followed-up to assess the prorportion of ADEs lead to hospitaliztion.


RESULTS
A total of 4764 patients were included in the study. 5.9% of all visits were considered to be drug-related. The highest percentage of ADEs was observed in the age group less than 20 and more than 80 years. ADRs accounted for 45% of all ADEs, followed by patient non-compliance (28%). Patient and physician non-compliance were the main causes of drug-related hospital admissions. 52% of all ADE-related visits and 55% of ADE-related admissions were considered to be preventable. Non-steroidal antiinflammatory agents, oral hypoglycemics and antitubercular drugs were responsible for 37% of all ADRs. Non-compliance was mainly seen in hypertensives, asthmatics and epileptics.


CONCLUSIONS
ADEs account for a sizable proportion of all visits to a medical emergency unit and some are serious enough to require hospitaliztion. A large number of ADE-related visits and admissions are preventable which highlights the importance of public education on the proper use of drugs, and also the need for regulation of the practice of unregistered medical practitioners in developing countries.
Malhotra
S
S
Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Jain
S
S
Pandhi
P
P
D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000009:adverse effects; D000995:Antitubercular Agents / Q000009:adverse effects; D003906:Developing Countries; D064420:Drug-Related Side Effects and Adverse Reactions; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects; D007194:India; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D011787:Quality of Health Care
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000959:Antihypertensive Agents; D000995:Antitubercular Agents; D007004:Hypoglycemic Agents