Drug-related hospital admissions in a generic pharmaceutical system.
1. Generically based pharmaceutical systems exist in a few countries of the world, such as Iran. Most developed countries have free market pharmaceutical systems. Drug-related problems (DRP) have been reported mostly in the Western world but few data are available for generic systems. In this study, we tried to measure the prevalence of drug-related problems leading to hospital admissions in Isfahan, Iran. 2. One thousand consecutive hospital admissions in three major teaching hospitals were studied for a period of 6 months for the presence of DRP as a cause of hospital admissions. Two subcategories of DRP were considered: (i) drug therapy failure; and (ii) adverse drug reactions. Preventability and outcome measures were also assessed. Medications responsible for DRP were classified according to the Anatomic Therapeutic Chemical (ATC) classification of the World Health Organization. 3. Of the 1000 admissions studied, 115 (11.5%) were owing to DRP, 81% as a result of drug therapy failure and 19% as adverse drug reactions. A total of 106 out of the 115 DRP cases (92%) were either preventable or probably preventable, most of which had to do with either prescriber or patient error. An overview of DRP showed that 58.3% resulted in complete recovery, 33.9% in relative recovery and 7.8% in death. Close to 1% of hospital admissions resulted in DRP-related deaths. 4. The overall prevalence of hospital admissions caused by DRP is similar to that in free market pharmaceutical systems. The high preventability rate of these problems should alert clinicians and policy makers to design strategies to curtail this. Also, reasons for differences in subtypes of DRP between the results of this study and those of the literature from free market systems needs to be investigated further.
Zargarzadeh
A H
AH
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran. zargarzadeh@pharm.mui.ac.ir
Emami
M H
MH
Hosseini
F
F
D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D003695:Delivery of Health Care / Q000379:methods / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000139:chemically induced / Q000401:mortality; D016568:Drugs, Generic / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D004522:Educational Status; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D007492:Iran; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D020127:Recovery of Function / Q000187:drug effects; D012307:Risk Factors; D017211:Treatment Failure
D016568:Drugs, Generic