Self-medication with over-the-counter and prescribed drugs causing adverse-drug-reaction-related hospital admissions: results of a prospective, long-term multi-centre study.

IF 4 2区医学 Q1 PHARMACOLOGY & PHARMACY

Drug Safety Pub Date : 2014-04-01 DOI:10.1007/s40264-014-0141-3

Sven Schmiedl, Marietta Rottenkolber, Joerg Hasford, Dominik Rottenkolber, Katrin Farker, Bernd Drewelow, Marion Hippius, Karen Saljé, Petra Thürmann

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引用次数: 106

Abstract

Background: Self-medication, including both the use of over-the-counter (OTC) drugs and the use of formerly prescribed drugs taken without a current physician's recommendation, is a public health concern; however, little data exist regarding the actual risk.

Objective: We aimed to analyse self-medication-related adverse drug reactions (ADRs) leading to hospitalisation.

Methods: In a multi-centre, observational study covering a hospital catchment area of approximately 500,000 inhabitants, we analysed self-medication-related ADRs leading to hospital admissions in internal medicine departments. Data of patients with ADRs were comprehensively documented, and ADR causality was assessed using Bégaud's algorithm. The included ADRs occurred between January 2000 and December 2008 and were assessed to be at least 'possibly' drug related.

Results: Of 6,887 patients with ADRs, self-medication was involved in 266 (3.9 %) patients. In 143 (53.8 %) of these patients, ADRs were due to OTC drugs. Formerly prescribed drugs and potential OTC drugs accounted for the remaining ADRs. Most self-medication-related ADRs occurred in women aged 70-79 years and in men aged 60-69 years. Self-medication-related ADRs were predominantly gastrointestinal complaints caused by non-steroidal anti-inflammatory drugs (most frequently OTC acetylsalicylic acid [ASA, aspirin]). In 102 (38.3 %) of the patients with self-medication-related ADRs, a relevant drug-drug interaction (DDI), occurring between a self-medication and a prescribed medication, was present (most frequently ASA taken as an OTC drug and prescribed diclofenac).

Conclusion: In the general population, self-medication plays a limited role in ADRs leading to hospitalisation. However, prevention strategies focused on elderly patients and patients receiving interacting prescribed drugs would improve patient safety.

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使用非处方药和处方药进行自我药物治疗导致与药物不良反应相关的住院:一项前瞻性、长期多中心研究的结果

背景:自我用药，包括使用非处方药物和使用未经当前医生建议的以前处方药物，是一个公共卫生问题;然而，关于实际风险的数据很少。目的:分析导致住院的自我用药相关药物不良反应(adr)。方法:在一项覆盖约50万居民的医院集水区的多中心观察性研究中，我们分析了导致内科住院的自我用药相关不良反应。对ADR患者的资料进行全面记录，并采用b ·······算法评估ADR的因果关系。纳入的不良反应发生在2000年1月至2008年12月之间，经评估至少“可能”与药物有关。结果:6887例不良反应患者中，有266例(3.9%)患者进行了自我药疗。其中143例(53.8%)患者的不良反应是由非处方药引起的。以前的处方药和潜在的非处方药占了剩余的adr。大多数与自我用药相关的不良反应发生在70-79岁的女性和60-69岁的男性。与自我用药相关的不良反应主要是由非甾体类抗炎药(最常见的是非处方药乙酰水杨酸[ASA，阿司匹林])引起的胃肠道疾病。在102例(38.3%)自我用药相关不良反应患者中，存在相关药物-药物相互作用(DDI)，发生在自我用药和处方药之间(最常见的是ASA作为OTC药物和处方双氯芬酸)。结论:在一般人群中，自我药疗对不良反应导致住院治疗的作用有限。然而，针对老年患者和接受相互作用处方药的患者的预防策略将改善患者安全。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Safety 医学-毒理学

CiteScore

7.60

自引率

7.10%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.