title: Quick assessment of drug-related admissions over time (QUADRAT study).
abstract: OBJECTIVE
  To develop a computerized prescreening procedure for the identification of possible/probably Hospital Admissions potential Related to Medications (HARMs).
  
  
  METHODS
  Pairs of drugs and reasons for hospitalization (generated automatically from the PHARMO record linkage database by using two data mining techniques) were assessed manually to determine whether they represented pharmacologically plausible adverse drug events (PP-ADEs). Two crude samples of these PP-ADEs (from 2005 and 2008) were examined manually to establish causality and preventability on the basis of hospital discharge letters plus medication dispensing data. The results were used to calculate the positive predictive value (PPV) of the crude causality PP-ADEs, the net percentage of possible/probably HARMs, and their potential preventability.
  
  
  RESULTS
  Data mining by Gamma Poisson Shrinkage and trend analysis produced 1330 and 2941 significant drug-event pairs, respectively. After manual assessment, 307 different PP-ADEs remained. The annual prevalence of these PP-ADEs was stable at approximately 8% throughout 2000-2009. Manual assessment of two samples of crude PP-ADEs showed that their causality PPV was 53.7% (95%CI: 52.7%-54.7%) in 2005 and 47.9% (95%CI: 46.9%-49.0%) in 2008. The net contribution of possible/probably HARMs to all acute admissions was 4.6% (95%CI: 4.5%-4.8%) in 2005 and 3.9% (95%CI: 3.8%-4.0%) in 2008. The potential preventability of all possible/probably HARMs in the two samples was 19.3% (95%CI: 18.5-20.1).
  
  
  CONCLUSIONS
  Automated pre-selection of PP-ADEs is an efficient way to monitor crude trends. Further validation and manual assessment of the automatically selected hospitalizations is necessary to get a more detailed and precise picture.
authors: IQ Healthcare, Radboud University Medical Center (RUMC), Nijmegen, The Netherlands; Community Pharmacy Groesbeek, Groesbeek, The Netherlands.
authors: Margaretha F
authors: MF
authors: Warlé-van Herwaarden
authors: Vera E
authors: VE
authors: Valkhoff
authors: Ron M C
authors: RM
authors: Herings
authors: Marjolein
authors: M
authors: Engelkes
authors: Jan C
authors: JC
authors: van Blijderveen
authors: Eline M
authors: EM
authors: Rodenburg
authors: Sandra
authors: S
authors: de Bie
authors: Jelmer
authors: J
authors: Alsma
authors: Caroline
authors: C
authors: van de Steeg-Gompel
authors: Cornelis
authors: C
authors: Kramers
authors: Ronald H B
authors: RH
authors: Meyboom
authors: Miriam C J M
authors: MC
authors: Sturkenboom
authors: Peter A G M
authors: PA
authors: De Smet
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000209:etiology; D055695:Electronic Prescribing / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008498:Medical Record Linkage; D009426:Netherlands; D015995:Prevalence
keywords: Netherlands/epidemiology; adverse drug events; computerized prescreening; drug-related hospitalization; hospitalization; pharmacoepidemiology; polypharmacy