Postdischarge adverse drug reactions in primary care originating from hospital care in France: a nationwide prospective study.
OBJECTIVE
To describe and estimate the incidence and preventability of postdischarge adverse drug reactions (ADRs) detected in primary care in France.


METHODS
Prospective study of patients referred to hospital by participating general practitioners (GPs). These GPs reported all cases of an adverse reaction to a drug instituted in hospital among patients who consulted them within 30 days of discharge.


METHODS
305 general practices from all French regions.


METHODS
7540 patients referred by GPs to private or public hospitals.


METHODS
The incidence for postdischarge ADRs in primary care, and their preventability.


RESULTS
30 cases of postdischarge ADR were detected in 29 re-consulting patients, yielding a minimal incidence for France of 0.4 per 100 admissions (95% confidence interval 0.3 to 0.6). The ADRs were assessed as serious in 60% of cases. The main drug classes implicated were cardiovascular drugs (8 ADRs), oral anticoagulants (6), psychoactive drugs (4), antidiabetics (3), and opioid analgesics (3). Patients experiencing a postdischarge ADR were older than patients not experiencing one (median age: 77 vs 68 years; p = 0.004). Detected ADRs were considered preventable in 59% of cases.


CONCLUSIONS
Physicians and patients should be aware of the possible occurrence of postdischarge ADRs. Patient information in hospital, close postdischarge follow-up of patients at risk, and appropriate transmission of information between hospital physicians and GPs can help to prevent them.
Letrilliart
L
L
WHO Collaborating Centre for Electronic Disease Surveillance, National Institute for Health and Medical Research (INSERM), Université Paris 6, France.
Hanslik
T
T
Biour
M
M
Fagot
J P
JP
Guiguet
M
M
Flahault
A
A
D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005260:Female; D005602:France; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires