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ABSTRACT: Objective(s)
To obtain reliable information about the incidence of adverse drug reactions, and identify potential areas where intervention may reduce the burden of ill-health.Design
Prospective observational study.Setting
A large tertiary children's hospital providing general and specialty care in the UK.Participants
All acute paediatric admissions over a one year period.Main exposure
Any medication taken in the two weeks prior to admission.Outcome measures
Occurrence of adverse drug reaction.Results
240/8345 admissions in 178/6821 patients admitted acutely to a paediatric hospital were thought to be related to an adverse drug reaction, giving an estimated incidence of 2.9% (95% CI 2.5, 3.3), with the reaction directly causing, or contributing to the cause, of admission in 97.1% of cases. No deaths were attributable to an adverse drug reaction. 22.1% (95% CI 17%, 28%) of the reactions were either definitely or possibly avoidable. Prescriptions originating in the community accounted for 44/249 (17.7%) of adverse drug reactions, the remainder originating from hospital. 120/249 (48.2%) reactions resulted from treatment for malignancies. The drugs most commonly implicated in causing admissions were cytotoxic agents, corticosteroids, non-steroidal anti-inflammatory drugs, vaccines and immunosuppressants. The most common reactions were neutropenia, immunosuppression and thrombocytopenia.Conclusions
Adverse drug reactions in children are an important public health problem. Most of those serious enough to require hospital admission are due to hospital-based prescribing, of which just over a fifth may be avoidable. Strategies to reduce the burden of ill-health from adverse drug reactions causing admission are needed.
SUBMITTER: Gallagher RM
PROVIDER: S-EPMC3514275 | biostudies-literature | 2012
REPOSITORIES: biostudies-literature
Gallagher Ruairi M RM Mason Jennifer R JR Bird Kim A KA Kirkham Jamie J JJ Peak Matthew M Williamson Paula R PR Nunn Anthony J AJ Turner Mark A MA Pirmohamed Munir M Smyth Rosalind L RL
PloS one 20121204 12
<h4>Objective(s)</h4>To obtain reliable information about the incidence of adverse drug reactions, and identify potential areas where intervention may reduce the burden of ill-health.<h4>Design</h4>Prospective observational study.<h4>Setting</h4>A large tertiary children's hospital providing general and specialty care in the UK.<h4>Participants</h4>All acute paediatric admissions over a one year period.<h4>Main exposure</h4>Any medication taken in the two weeks prior to admission.<h4>Outcome mea ...[more]