The incidence and nature of drug-related admissions to hospital

Abstract

Aim. To determine the nature and incidence of adult drug-related admissions. Subjects and Settings. Adult patients admitted via the medical admissions ward at Addenbrooke's NHS Trust. Outcome Measures. The incidence and type of drug-related admissions, the main classes or groups of drugs involved and the clinical severity. Design. Survey of acute adult admissions over a 9-week period. Results. 10.1% of admissions were identified as drug-related; 18% of these drug-related admissions were due to drug therapy failures, 52% were related to adverse drug reactions (ADRs) and 30% were related to issues to overdose or abuse. Non and poor compliance was the most frequently implicated category of admissions relating to drug therapy failures, whereas expected side effects and drug-related toxicity accounted for almost all the admissions related to ADRs. 50% of drug-related admissions were categorised as definitely drug-related, 17% as probably drug related and 29% as possibly drug related. 12% were classified as mild, 40% as moderate and 44% as severe. The two most frequently implicated BNF categories were cardiovascular system and central nervous system drugs, representing 67% of drug-related admissions, followed by NSAIDs, which alone accounted for 12.5% of all drug-related admissions. Conclusions. Drug-related admissions are a significant problem within the UK health system. The most frequently implicated drug classes in this study were cardiovascular drugs, central nervous system drugs and NSAIDS. Our findings provide support for Government recommendations on the role of hospital pharmacists in reducing errors and adverse events relating to drugs and the extended role for pharmacists in medicines management.