Adverse drug reactions are a major clinical problem, many studies showing that they account for about 2%-6% of all hospital admissions (Einarson, 1993; Bates et al., 1995a, 1995b, 1997; Classen et al., 1997). A recent meta-analysis suggested that adverse drug reactions were between the fourth and sixth commonest cause of
Table 6.1. The direct and indirect effects of adverse drug reactions.
Cause admission to hospitals, or attendance in primary care
Complicate hospital in-patient stay in 10%-20% of cases
Responsible for deaths, possibly as high as the fourth commonest cause of death
Increase length of hospital stay
Increase cost of patient care
Major economic burden on the pharmaceutical industry
Adversely affect patient quality of life
Cause patients to lose confidence in their doctors
Occurrence of toxicity in a minority of patients will preclude use of the drug in the majority of patients
Mimic disease and result in unnecessary investigations and/or delay treatment death in the United States in 1994 (Lazarou et al, 1998). Recent surveys have also indicated that adverse drug events are associated with an increased length of stay in hospital of 2 days, and an increased cost of approximately $2500 per patient (Bates et al., 1997; Classen et al., 1997). Besides the above, adverse drug reactions can also have many other indirect effects (Table 6.1), which in total, highlight the overall importance of adverse drug reactions in modern medicine.
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