Prepoznavanje in poročanje neželenih učinkov zdravil pri bolnikih na Interni kliniki Univerzitetnega kliničnega centra Ljubljana

Škorjanc, Špela (author), Kerec Kos, Mojca (mentor), Dobravc Verbič, Matej (co-mentor)

Neželeni učinki zdravil negativno vplivajo na bolnikovo stanje in izid zdravljenja z zdravili ter privedejo do daljšega časa zdravljenja v bolnišnicah in s tem povezanih višjih stroškov. Glede na rezultate raziskav znaša delež bolnikov, sprejetih v bolnišnico zaradi neželenih učinkov zdravil, med 3,5 in 13 procentov, delež bolnikov z neželenim učinkom v času hospitalizacije pa med 0,6 in 3,2 procenta, v nekaterih raziskavah tudi do 20 procentov. Glavni namen neintervencijske retrospektivne raziskave je bil določiti pogostost in ovrednotiti neželene učinke zdravil pri bolnikih, sprejetih na oddelke Interne klinike Univerzitetnega kliničnega centra Ljubljana preko Internistične prve pomoči. Spremljali smo neželene učinke, ki so bili vzrok za sprejem in neželene učinke zdravil v času hospitalizacije. Pregledali smo podatke o skupno 750 bolnikih, ki so bili sprejeti v obdobju dveh mesecev. Določili smo tudi pogostost poročanja in ustreznost šifriranja neželenih učinkov z oznakami Mednarodne klasifikacije bolezni ter v besedilu odpustnih pisem poiskali največkrat uporabljene ključne besede, ki so nakazovale na pojav neželenega učinka zdravil. Domnevni neželeni učinek zdravil smo prepoznali pri 180/750 bolnikov (24,0 procentov). Zaradi neželenega učinka je bilo sprejetih 73 bolnikov (9,7 procentov), na oddelku pa se je neželeni učinek pojavil pri 125 bolnikih (16,7 procentov). Največ neželenih učinkov je spadalo med presnovne in prehranske motnje (105/262; 40,1 procent). Najpogosteje je neželeni učinek povzročil furosemid, za njim pa varfarin, pri katerem smo zabeležili tudi največ potencialnih interakcij z zdravili. Potrjenih neželenih učinkov zdravil je bilo 95 (36,3 procentov). Med resne smo uvrstili 143 (54,6 procentov), med hude pa 36 (13,7 procentov) neželenih učinkov zdravil. V odpustnem pismu so bili ustrezno šifrirani le 4 primeri (1,5 procentov), preko bolnišničnega informacijskega sistema pa je bilo poročanih 6 (2,3 procenti) neželenih učinkov. V besedilu odpustnih pisem smo v povezavi z neželenimi učinki najpogosteje opazili ključno besedo 'ukinili'.

• Language: Slovenian
• Keywords: neželeni učinki zdravil, pogostost, interakcije med zdravili, poročanje, farmakovigilanca
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2021
• PID: 20.500.12556/RUL-133126
• Publication date in RUL: 12.11.2021

Secondary language

• Language: English
• Title: Recognition and reporting of adverse drug reactions in patients at the Division of Internal Medicine, University Medical Centre Ljubljana

Abstract

Adverse drug reactions have negative effects on patient’s condition and drug treatment outcome and lead to longer hospital stays and related higher costs. According to research, the proportion of patients admitted to hospital due to adverse drug reactions ranges from 3.5 to 13 percent, and the proportion of patients with adverse drug reaction during hospitalization ranges from 0.6 to 3.2 percent, in some studies even up to 20 percent. The main purpose of non-interventional retrospective study was to determine the frequency and to evaluate adverse drug reactions in patients, admitted to the Division of Internal Medicine, University Medical Centre Ljubljana, through Medical Emergency Department. Both adverse drug reactions as a cause of admission and in-hospital adverse drug reactions were followed. We reviewed data from the medical records of 750 patients admitted over a two-month period. We determined the frequency of reporting and the adequacy of coding adverse drug reactions with International Classification of Diseases codes, and searched the text of discharge letters for the most frequently used keywords that indicated the occurrence of an adverse drug reaction. Suspected adverse drug reactions were identified in 180/750 patients (24.0 percent). 73 (9.7 percent) patients were admitted due to an adverse drug reaction and 125 (16.7 percent) patients experienced an in-hospital adverse drug reaction. The majority of adverse drug reactions belonged to the group of metabolism and nutrition disorders (105/262; 40.1 percent). Furosemide was the most commonly implicated drug, followed by warfarin, which was also associated with the highest number of potential drug interactions. There were 95 (36.3 percent) confirmed adverse drug reactions. 143 (54.6 percent) adverse drug reactions were classified as serious, and 36 (13.7 percent) were classified as severe. Only 4 cases of adverse drug reactions (1.5 percent) were appropriately coded in discharge letters, and 6 (2.3 percent) were reported via the hospital information system. The most often recognised keyword related to adverse drug reactions in the text of discharge letters was 'discontinued'.

• Keywords: adverse drug reactions, frequency, drug interactions, reporting, pharmacovigilance