The Economic Burden of Adverse Drug Reactions Leading to and Occurring During Hospitalization

• Autor(a) principal: Bastos, Paulo
• Data de Publicação: 2016
• Outros Autores: Roque, Fátima, Carvajal, Alfonso, Herdeiro, Maria Teresa
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10314/3213
• topic: Adverse Drugs Reactions; costs; medicines use; safety

Background: Adverse drug reactions (ADRs) are a major public health problem because they are directly related to mortality, morbidity and costs [1–3]. Due to their nature and implications, ADRs may account for a considerable number of hospitalizations, lead to poorer prognostics, and prolong hospitalization length while increasing the overall direct and indirect hospitalization-associated costs [4–6]. Objective: To analyze the comparative economic impact of hospitalacquired ADRs as well as community acquired ADRs leading to hospitalization and to characterize their associated hospitalization length and costs, incidence, prevalence, risk factors, predictability, preventability, most frequently afflicted systems and most common involved drug groups. Methods: Systematic analysis performed on PubMed including all studies published prior to March 30th, 2016. Identified and retrieve studies (1617) were categorized as case reports, clinical studies, comparative studies, clinical trials, non-trial clinical studies, other observational studies, multicenter studies, other evaluation studies or otherwise journal articles. Only original studies in English or Portuguese language pertaining to adults and/or the elderly and reporting (as their main goal) cost resulting from ADRs/ADEs causing hospitalization and/or occurring during hospitalization were included. Studies performed on the pediatric population, those restricted to specific diseases (e.g. hypertension, chronic obstructive pulmonary disease), clinical conditions (e.g. cancer patients, trauma patients) or drug groups (e.g. antiretroviral therapy, chronic obstructive pulmonary disease), drug–drug comparative and modeling studies were all excluded from further analysis. Results: A total of 1617 studies were retrieved, and 1483 were in human subjects. 42 % of the studies were classified as Case Reports (n = 23), Clinical studies (n = 177), Comparative Studies (n = 189), Clinical Trials (n = 146), Non-Clinical Studies (n = 8), Other Observational Studies (n = 3), Multicenter Studies (n = 62), or Other Evaluation Studies (n = 21). Few studies pertaining to hospitalization-associated ADRs and resulting cost existed and were amenable to analysis. Results were reported as mean, median and/or range and plotted as bar charts. Conclusion: The economic burden of ADRs is not limited to the direct hospitalization-associated implications, instead having more extensive societal implications. While the most commonly prescribed drugs account for the majority of ADRs, a restricted number of medications and ADRs account for the majority of the economic burden. Therefore, identifying and targeting this limited set is of paramount importance to reduce the health-associated and economic burden resulting from ADRs.