Ten-year trends in hospital admissions for adverse drug reactions in England 1999-2009.
OBJECTIVE
Adverse drug reactions (ADR) are an important cause of morbidity and mortality. We analysed trends in hospital admissions associated with ADRs in English hospitals between 1999 and 2008.


METHODS
Data from the Hospital Episode Statistics database were examined for all English hospital admissions (1999-2008) with a primary or secondary diagnosis of an ADR recorded.


METHODS
All NHS (public) hospitals in England.


METHODS
The number of admissions and in-hospital mortality rate with a primary (codes including 'adverse drug reaction', 'drug-induced', 'due to drug', 'due to medicament' or 'drug allergy') or secondary diagnosis of ADR (ICD-10 Y40-59) were obtained and analysed. Further analysis for the year 2008-2009 was performed with regard to age, gender, proportion aged >65 yrs and total bed-days.


RESULTS
Between 1999 and 2008, there were 557,978 ADR-associated admissions, representing 0.9% of total hospital admissions. Over this period the annual number of ADRs increased by 76.8% (from 42,453 to 75,076), and in-hospital mortality rate increased by 10% (from 4.3% to 4.7%). In 2008, there were 6,830,067 emergency admissions of which 75,076 (1.1%) were drug-related. Systemic agents were most commonly implicated (19.2%), followed by analgesics (13.3%) and cardiovascular drugs (12.9%).There has been a near two-fold increase in nephropathy and cardiovascular consequences secondary to drugs and a 6.8% fall in mental and behavioural disorders due to drugs. Conclusions ADRs have a major impact on public health. Our data suggest the number of ADR admissions has increased at a greater rate than the increase in total hospital admissions; some of this may be due to improved diagnostic coding. However, in-hospital mortality due to ADR admissions also increased during the period. Our findings should prompt policymakers to implement further measures to reduce ADR incidence and their associated in-hospital mortality, and methods to improve the recording of ADRs.
Department of Primary Care and Public Health, Imperial College London Charing Cross Campus, London W6 8RP, UK.
Tai-Yin
TY
Wu
Min-Hua
MH
Jen
Alex
A
Bottle
Mariam
M
Molokhia
Paul
P
Aylin
Derek
D
Bell
Azeem
A
Majeed
D002318:Cardiovascular Diseases / Q000139:chemically induced; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000639:trends; D004739:England / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006761:Hospitals / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D038801:International Classification of Diseases; D007674:Kidney Diseases / Q000139:chemically induced; D001523:Mental Disorders / Q000139:chemically induced