Importance Of Adverse Drug Reactions

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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