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Trends in hospital admissions for adverse drug reactions in England

An adverse drug reaction (ADR) is an undesirable effect of a drug beyond its anticipated therapeutic effects occurring during clinical use, and is one of the major causes of iatrogenic disease. ADRs cause significant morbidity and mortality and increase the length of hospital stays. The economic burden of ADRs on the British NHS is also high, accounting for considerable extra NHS costs. A recent study by Dr Tai-Yin Wu and colleagues published in the Journal of the Royal Society of Medicine examined hospital admissions associated with ADRs in all NHS English hospitals in the past 10 years, using the Hospital Episode Statistics database.

Between 1999 and 2008, there were 557,978 ADR-associated admissions, representing 0.9% of total hospital admissions. Over this period the annual number of ADRs increased by 76.8% (from 42,453 to 75,076), and in-hospital mortality rate increased by 10% (from 4.3% to 4.7%). In 2008, there were 6,830,067 emergency admissions of which 75,076 (1.1%) were drug-related. Systemic agents were most commonly implicated (19.2%), followed by analgesics (13.3%) and cardiovascular drugs (12.9%).There has been a near two-fold increase in nephropathy and cardiovascular consequences secondary to drugs and a 6.8% fall in mental and behavioural disorders due to drugs.

The study confirmed that ADRs have a major impact on public health, with the number of ADR admissions due to ADRs increasing at a greater rate than the increase in total hospital admissions. In-hospital mortality due to ADR admissions also increased during the study period. These findings should prompt policymakers to implement further measures to reduce ADR incidence and their associated in-hospital mortality, and develop educational interventions to improve the recording of ADRs by clinicians.

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