title: Development of an adverse drug reaction risk assessment score among hospitalized patients with chronic kidney disease.
abstract: BACKGROUND
  Adverse drug reactions (ADRs) represent a major burden on the healthcare system. Chronic kidney disease (CKD) patients are particularly vulnerable to ADRs because they are usually on multiple drug regimens, have multiple comorbidities, and because of alteration in their pharmacokinetics and pharmacodynamic parameters. Therefore, one step towards reducing this burden is to identify patients who are at increased risk of an ADR.
  
  
  OBJECTIVE
  To develop a method of identifying CKD patients who are at increased risk for experiencing ADRs during hospitalisation.
  
  
  METHODS
  Factors associated with ADRs were identified by using demographic, clinical and laboratory variables of patients with CKD stages 3 to 5 (estimated glomerular filtration rate, 10-59 ml/min/1.73 m2) who were admitted between January 1, 2012, and December 31, 2012, to the renal unit of Dubai Hospital. An ADR risk score was developed by constructing a series of logistic regression models. The overall model performance for sequential models was evaluated using Akaike Information Criterion for goodness of fit. Odd ratios of the variables retained in the best model were used to compute the risk scores.
  
  
  RESULTS
  Of 512 patients (mean [SD] age, 60 [16] years), 62 (12.1%) experienced an ADR during their hospitalisation. An ADR risk score included age 65 years or more, female sex, conservatively managed end-stage renal disease, vascular disease, serum level of C-reactive protein more than 10 mg/L, serum level of albumin less than 3.5 g/dL, and the use of 8 medications or more during hospitalization. The C statistic, which assesses the ability of the risk score to predict ADRs, was 0.838; 95% CI, 0.784-0.892).
  
  
  CONCLUSIONS
  A score using routinely available patient data can be used to identify CKD patients who are at increased risk of ADRs.
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, Penang, Malaysia.
authors.forename: Fatemeh Saheb
authors.initials: FS
authors.lastname: Sharif-Askari
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, Penang, Malaysia.
authors.forename: Syed Azhar
authors.initials: SA
authors.lastname: Syed Sulaiman
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, Penang, Malaysia.
authors.forename: Narjes
authors.initials: N
authors.lastname: Saheb Sharif-Askari
authors.affiliation: Pharmacy Department, Dubai Health Authority, Dubai, United Arab Emirates.
authors.forename: Ali
authors.initials: A
authors.lastname: Al Sayed Hussain
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate; D006470:Hemorrhage / Q000139:chemically induced; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D012306:Risk; D018570:Risk Assessment
chemical_list: D000925:Anticoagulants
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