Dataset Information

Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence.

ABSTRACT:

Introduction

South Africa has the world's largest antiretroviral treatment programme, which may contribute to the adverse drug reaction (ADR) burden. We aimed to determine the proportion of adult non-trauma emergency unit (EU) presentations attributable to ADRs and to characterise ADR-related EU presentations, stratified according to HIV status, to determine the contribution of drugs used in management of HIV and its complications to ADR-related EU presentations, and identify factors associated with ADR-related EU presentation.

Methods

We conducted a retrospective folder review on a random 1.7% sample of presentations over a 12-month period in 2014/2015 to the EUs of two hospitals in Cape Town, South Africa. We identified potential ADRs with the help of a trigger tool. A multidisciplinary panel assessed potential ADRs for causality, severity, and preventability.

Results

We included 1010 EU presentations and assessed 80/1010 (7.9%) as ADR-related, including 20/239 (8.4%) presentations among HIV-positive attendees. Among HIV-positive EU attendees with ADRs 17/20 (85%) were admitted, versus 22/60 (37%) of HIV-negative/unknown EU attendees. Only 5/21 (24%) ADRs in HIV-positive EU attendees were preventable, versus 24/63 (38%) in HIV-negative/unknown EU attendees. On multivariate analysis, only increasing drug count was associated with ADR-related EU presentation (adjusted odds ratio 1.10 per additional drug, 95% confidence interval 1.03 to 1.18), adjusted for age, sex, HIV status, comorbidity, and hospital.

Conclusions

ADRs caused a significant proportion of EU presentations, similar to findings from other resource-limited settings. The spectrum of ADR manifestations in our EUs reflects South Africa's colliding epidemics of infectious and non-communicable diseases. ADRs among HIV-positive EU attendees were more severe and less likely to be preventable.

SUBMITTER: Mouton JP

PROVIDER: S-EPMC7787921 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence.

Mouton Johannes P JP Jobanputra Nicole N Njuguna Christine C Gunter Hannah H Stewart Annemie A Mehta Ushma U Lahri Sa'ad S Court Richard R Igumbor Ehimario E Maartens Gary G Cohen Karen K

African journal of emergency medicine : Revue africaine de la medecine d'urgence 20201130 1

<h4>Introduction</h4>South Africa has the world's largest antiretroviral treatment programme, which may contribute to the adverse drug reaction (ADR) burden. We aimed to determine the proportion of adult non-trauma emergency unit (EU) presentations attributable to ADRs and to characterise ADR-related EU presentations, stratified according to HIV status, to determine the contribution of drugs used in management of HIV and its complications to ADR-related EU presentations, and identify factors ass ...[more]

PMID: 33437593

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Dataset Information

Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence.

Introduction

Methods

Results

Conclusions

Publications

Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence.

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