Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Ho KH(1), Yung L(1), Leung A(2),Yam PW(3), Wong KT(1), Blais JE(2), Chu LM(1)
Affiliation :
(1)Department of Pharmacy, Tuen Mun Hospital
(2)Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong
(3)Department of Medicine and Geriatrics, Tuen Mun Hospital
Introduction :
Adverse drug reaction (ADR) is one of the main contributors to unplanned, emergent hospital admissions around the world, posing a heavy workload and financial burden to the healthcare systems. The local situation on ADR-led hospital admission was only reviewed from 1992 to 1993. The research results could not be referred to due to significant changes in population structure and prescribing practice, and the introduction of novel therapeutic agents over the decades. Thus, research on the latest local trend of ADR-led hospital admission was proposed.
Objectives :
To provide a preliminary review of the latest trend of local ADR-led hospital admission with the prevalence, identification of drug class and risk factors associated, and estimation of the percentage of such admissions being preventable.
Methodology :
Patients aged 18 or above admitted to Tuen Mun Hospital after seeking medical service at Accident and Emergency in August 2021 were included in the analysis. Using a pre-defined list, patients with potential ADR were identified. The causality and preventability of ADR identified were assessed with different algorithms. Risk factor identification was done with statistical analyses using SPSS.
Ethics approval was granted by the New Territories West Cluster Research Ethics Committee, Hospital Authority (REC Reference No. NTWC/REC/22083).
Result & Outcome :
After reviewing 3271 cases, the prevalence of ADR-led hospital admission was estimated to be 5.5%, with 197 events identified in 181 cases.
Patients identified with ADR-led hospital admission were mainly associated with hypoglycemia, arrhythmia, and gastrointestinal bleeding; the three main drug classes contributing to admissions were “drugs used in diabetes”, “drugs used in hypertension and heart failure”, and “drugs used in psychoses and related disorders”, as classified in the Hospital Authority Drug Formulary.
Age, polypharmacy, previous ADR history and abnormal renal function were identified as the risk factors for development of ADR-led hospital admission. Patients diagnosed with diabetes mellitus or hypertension were associated with significantly higher risks for ADR-led hospital admission. It was estimated that 38.6% of ADR-led hospital admission cases were preventable.
Local features of ADR-led hospital admission varied significantly from overseas. Efforts should be made to lower the prevalence of ADR-led hospital admission, reducing the financial and workload burden of the public healthcare system.
