title: Patterns of Adverse Drug Reaction in the Medical Wards of a Teaching Hospital: A Prospective Observational Cohort Study.
abstract: BACKGROUND
  According to the World Health Organization (WHO) definition, an Adverse Drug Reaction (ADR) is a response to a drug that is noxious and unintended and occurs at doses normally used in humans for the prophylaxis, diagnosis, and treatment of disease. The risk factors of ADR are multi-factorial and include poly-pharmacy, age, gender, race, genetics and inter-current disease.
  
  
  METHODS
  This was a hospital based, prospective, observational cohort study undertaken in a tertiary care hospital in south India to assess the different patterns of adverse drug reaction in medical wards over 6 months. The severity of ADR was assessed using Hartwig Siegel scale and causality by Naranjo and WHO UMC Scale. Preventability was assessed using Schumock and Thornton scale and other parameters such as incidence, onset, duration, management and outcome were also assessed. Risk factors were assessed by bi-variate logistic regression analysis and length of hospital stay by T test.
  
  
  RESULTS
  The incidence of ADR was 10.42% in medicine wards. The causality of ADR done by Naranjo scale showed that most of the ADRs were probable (7.38%). Anti-tubercular agents were the leading cause of ADR. Duration of hospitalization was significantly longer (7.18 ± 2.64 vs. 5.06 ± 2.13 days) in patients with ADR (Odds ratio 1.38, 95% Confidence interval 1.26 to 1.51). 7.28% of ADRs were moderately severe. Seriousness criteria assessment showed that 0.33% were serious reactions. Most of the ADRs were definitely preventable. Most of the ADRs were managed by discontinuing the suspected drug. The present study showed female gender predominance over males for ADRs and no relationship with age.
  
  
  CONCLUSIONS
  Adverse drug reactions impose significant burden on hospitals through prolonging patient stay and by increasing admission rates. The occurrence of ADR in this study was higher when compared to that reported in previous studies. This study highlights the importance of ADR reporting among ADR reporting among health care professionals in hospital.
authors.affiliation: Christian Medical College Hospital, Vellore 632 004, India. peterjohnvictor@yahoo.com.au.
authors.forename: John V
authors.initials: JV
authors.lastname: Peter
authors.forename: Greeshma H
authors.initials: GH
authors.lastname: Varghese
authors.forename: Hanna
authors.initials: H
authors.lastname: Alexander
authors.forename: Neethu R
authors.initials: NR
authors.lastname: Tom
authors.forename: V
authors.initials: V
authors.lastname: Swethalekshmi
authors.forename: Catherine
authors.initials: C
authors.lastname: Truman
authors.forename: T R Ashok
authors.initials: TR
authors.lastname: Kumar
authors.forename: T
authors.initials: T
authors.lastname: Sivakumar
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006748:Hospital Departments / Q000639:trends*; D006784:Hospitals, Teaching / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult