Article

Computerized surveillance of adverse drug reactions in hospital: Implementation

Department of Medicine, Hadassah University Hospital, Jerusalem, Israel.
European Journal of Clinical Pharmacology (Impact Factor: 2.97). 02/1999; 54(11):887-92. DOI: 10.1007/s002280050571
Source: PubMed

ABSTRACT

To implement and measure the effects of automatic computerized laboratory signals (ALS) as a detection support tool of adverse drug reactions (ADRs) in hospital.
This was a prospective observational study of a total of 192 patients (199 sequential medical admissions) during a 2-month period in a 34-bed medical ward at the Hadassah University Hospital, Jerusalem, Israel. The study involved the routine (daily) distribution to staff physicians of lists of automatic signals generated from computerized laboratory data as potential indicators of ADRs. Patient charts were reviewed by the clinical pharmacology team for ADRs and to see whether these were recognized by the staff physicians.
Seventy-one ADRs were detected in 64 of the 199 (32%) admissions. Twenty-seven per cent of the ADRs were serious, 9% of the admissions were due to ADRs. Two hundred and ninety-five ALS were generated involving 69% of the admissions. Sixty-one per cent of the ADRs were identified by ALS. ALS were present in 58% of the ADR negative admissions. Eighty-five per cent of the ADRs were recognized as such and 19% of the ALS-positive ADRs were not recognized by the staff physicians.
The routine implementation of ALS doubled the number of ADRs recognized by the physicians while patients were hospitalized in the medical ward. The use of the system appeared valid, simple and potentially cost-effective.

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    • "Drug interactions can lead to an increase or a decrease of the drug effects or cause other serious reactions. For example, co administration of a drug metabolized by Cytochrome P450 3A4 (CYP3A4) and the drug inhibiting CYP3A4, such as cyclosporine and clarithromycin, respectively, result in delayed clearance and elevated blood levels of the former drug, which increases and prolongs both the therapeutic and adverse effects [4] A common misconception is that a drug's effects can be clearly divided into two categories : desired(or therapeutic effects) and undesired (or side effects).Actually ,most drugs produce several effects ,but a physician usually wants a experience only one (or a few) of them; the other effects are hence regarded as undesired. Although most people including appropriate for effects that are undesired, unpleasant, noxious or potentially harmful. "

    Full-text · Dataset · Feb 2016
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    • "Drug interactions can lead to an increase or a decrease of the drug effects or cause other serious reactions. For example, co administration of a drug metabolized by Cytochrome P450 3A4 (CYP3A4) and the drug inhibiting CYP3A4, such as cyclosporine and clarithromycin, respectively, result in delayed clearance and elevated blood levels of the former drug, which increases and prolongs both the therapeutic and adverse effects [4] A common misconception is that a drug's effects can be clearly divided into two categories : desired(or therapeutic effects) and undesired (or side effects).Actually ,most drugs produce several effects ,but a physician usually wants a experience only one (or a few) of them; the other effects are hence regarded as undesired. Although most people including appropriate for effects that are undesired, unpleasant, noxious or potentially harmful. "

    Full-text · Dataset · Feb 2016
  • Source
    • "Drug interactions can lead to an increase or a decrease of the drug effects or cause other serious reactions. For example, co administration of a drug metabolized by Cytochrome P450 3A4 (CYP3A4) and the drug inhibiting CYP3A4, such as cyclosporine and clarithromycin, respectively, result in delayed clearance and elevated blood levels of the former drug, which increases and prolongs both the therapeutic and adverse effects [4] A common misconception is that a drug's effects can be clearly divided into two categories : desired(or therapeutic effects) and undesired (or side effects).Actually ,most drugs produce several effects ,but a physician usually wants a experience only one (or a few) of them; the other effects are hence regarded as undesired. Although most people including appropriate for effects that are undesired, unpleasant, noxious or potentially harmful. "

    Full-text · Article · Feb 2016 · World Journal of Pharmaceutical Sciences
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