Hospitalizations and adverse drug events in the Brazilian unified health system: a ten-year retrospective analysis of routine data
DOI:
https://doi.org/10.11606/s1518-8787.2022056003913Palavras-chave:
Drug-related side effects and adverse reactions, Pharmacoepidemiology, Hospitalization, Databases, factualResumo
OBJECTIVE To describe the frequency and characteristics of hospitalizations for/with adverse drug events in the Brazilian unified health system routine data. METHODS Nationwide retrospective study using data obtained from a period of ten years from the Brazil Hospital Information System (SIH-SUS), an administrative database that registers hospitalizations in the unified health system. We selected hospitalizations with primary and/or secondary diagnosis related to adverse drug events according to a list of validated International Classification Disease 10th edition (ICD-10) codes. These events were described according to year, age group, sex, length of hospital stay, mortality, hospital costs, Brazilian geographical region, and category of ICD-10 codes. Crude hospitalization rates of adverse drug events per 100,000 inhabitants were obtained and Joinpoint Regression was used to analyze temporal changes in these rates along the years. The most frequent ICD-10 codes were also identified. RESULTS Over ten years, 603,663 hospitalizations in Brazil were found in the database, out of which 2.5% of the patients died. Though 2009 had the highest prevalence of hospitalization per 100,000 inhabitants (32.57), no significant annual change in rates was found for the entire period. All age groups and sexes presented a jointpoint in temporal series; however, only women had a significative increase trend. The most frequent codes were from the chapter of mental and behavioral disorders (F19.2, F19.0, and F19.5 codes). CONCLUSIONS The database methodology can be useful to estimate frequencies of adverse drug events and perform characterization nationwide and to help monitor morbidity along the years.
Referências
Sousa-Pinto B, Marques B, Lopes F, Freitas A. Frequency and impact of adverse events in inpatients: a nationwide analysis of episodes between 2000 and 2015. J Med Syst. 2018;42(3):48. https://doi.org/10.1007/s10916-018-0898-5
Poudel DR, Acharya P, Ghimire S, Dhital R, Bharati R. Burden of hospitalizations related to adverse drug events in the USA: a retrospective analysis from large inpatient database. Pharmacoepidemiol Drug Saf. 2017;26(6):635-41. https://doi.org/10.1002/pds.4184
Pardo Cabello AJ, Del Pozo Gavilán E, Gómez Jiménez FJ, Mota Rodríguez C, Luna Del Castillo JD, Puche Cañas P. Drug-related mortality among inpatients: a retrospective observational study. Eur J Clin Pharmacol. 2016;72(6):731-6. https://doi.org/10.1007/s00228-016-2026-0
Laatikainen O, Miettunen J, Sneck S, Lehtiniemi H, Tenhunen O, Turpeinen M. The prevalence of medication-related adverse events in inpatients: a systematic review and meta-analysis. Eur J Clin Pharmacol. 2017;73(12):1539-49. https://doi.org/10.1007/s00228-017-2330-3
Stausberg J, Hasford J. Drug-related admissions and hospital-acquired adverse drug events in Germany: a longitudinal analysis from 2003 to 2007 of ICD-10-coded routine data. BMC Health Serv Res. 2011;11:134. https://doi.org/10.1186/1472-6963-11-134
Shamliyan TA, Kane RL. Drug-related harms in hospitalized Medicare beneficiaries: results from the Healthcare Cost and Utilization Project, 2000-2008. J Patient Saf. 2016;12(2):89-107. https://doi.org/10.1097/PTS.0000000000000106
Amelung S, Meid AD, Nafe M, Thalheimer M, Hoppe-Tichy T, Haefeli WE, et al. Association of preventable adverse drug events with inpatients’ length of stay: a propensity-matched cohort study. Int J Clin Pract. 2017;71(10):e12990. https://doi.org/10.1111/ijcp.12990
Wu TY, Jen MH, Bottle A, Molokhia M, Aylin P, Bell D, et al. Ten-year trends in hospital admissions for adverse drug reactions in England 1999–2009. R Soc Med. 2010;103(6):239-50. https://doi.org/10.1258/jrsm.2010.100113
Kane-Gill SL, Van Den Bos J, Handler SM. Adverse drug reactions in hospital and ambulatory care settings identified using a large administrative database. Ann Pharmacother. 2010;44(6):983-93. https://doi.org/10.1345/aph.1M726
Kuklik N, Stausberg J, Jöckel KH. Adverse drug events in German hospital routine data: a validation of International Classification of Diseases, 10th revision (ICD-10) diagnostic codes. PLoS One. 2017;12(11):e0187510. https://doi.org/10.1371/journal.pone.0187510
Mota DM, Vigo A, Kuchenbecker RS. Recomendações de códigos da CID-10 para vigilância de reações adversas e intoxicações a medicamentos. Cienc Saude Colet. 2018;23(9):3041-54. https://doi.org/10.1590/1413-81232018239.20692016
Cerqueira DRC, Alves PP, Coelho DSC, Reis MVM, Lima AS. Uma análise da Base de Dados do Sistema de Informação Hospitalar entre 2001 e 2018: dicionário dinâmico, disponibilidade dos dados e aspectos metodológicos para a produção de indicadores sobre violência. Rio de Janeiro: Instituto de Pesquisa Econômica Aplicada; 2019.
Agency for Healthcare Research and Quality, Patient Safety Network- PSNet. Medication errors and adverse drug events. Rockville, MD: AHRQ; 2019 [cited 2020 Mar 16]. Available from: https://psnet.ahrq.gov/primer/medication-errors-and-adverse-drug-events
World Health Organization. International Statistical Classification of Diseases and Related Health Problems - 10th revision; version 2019. Geneva (CH): WHO; 2019 [cited 2020 Mar 16]. Available from: https://icd.who.int/browse10/2019/en
National Cancer Institute, Division of Cancer Control & Population Sciences. Surveillance Research Program. The Joinpoint Regression Program, Version 4.8.0.1. Rockville, MD: NCI; 2020 [cited 2020 July 20]. Available from: https://surveillance.cancer.gov/joinpoint/
Santos GAS, Boing AC. [Hospitalizations and deaths from drug poisoning and adverse reactions in Brazil: an analysis from 2000 to 2014]. Cad Saude Publica. 2018;34(6):e00100917l. Portuguese. https://doi.org/10.1590/0102-311X00100917
Miguel A, Marques B, Freitas A, Lopes F, Azevedo L, Pereira AC. Detection of adverse drug reactions using hospital databases: a nationwide study in Portugal. Pharmacoepidemiol Drug Saf. 2013;22(8):907-13. https://doi.org/10.1002/pds.3468
Donaldson LJ, Kelley ET, Dhingra-Kumar N, Kieny MP; Sheikh A. Medication Without Harm: WHO’s Third Global Patient Safety Challenge. Lancet. 2017;389(10080):1680-1. https://doi.org/10.1016/S0140-6736(17)31047-4
Stausberg J. International prevalence of adverse drug events in hospitals: an analysis of routine data from England, Germany, and the USA. BMC Health Serv Res. 2014;14:125. https://doi.org/10.1186/1472-6963-14-125
Patel H, Bell D, Molokhia M, Srishanmuganathan J, Patel M, Car J, et al. Trends in hospital admissions for adverse drug reactions in England: analysis of national hospital episode statistics 1998–2005. BMC Clin Pharmacol. 2007;7:9. https://doi.org/10.1186/1472-6904-7-9
Paula TC, Bochner R, Montilla DER. Clinical and epidemiological analysis of hospitalizations of elderly due to poisoning and adverse effects of medications, Brazil from 2004 to 2008. Rev Bras Epidemiol. 2010;15(4):828-44. https://doi.org/10.1590/s1415-790x2012000400014
Lessa MA, Bochner R. Analysis of hospitalizations of children under one year of age due to drug intoxication and adverse events in Brazil. Rev Bras Epidemiol. 2008;11(4):660-74. https://doi.org/10.1590/S1415-790X2008000400013
Collao JF, Favereau R, Miranda R, Aceitón C. [Drug related harm in Chilean hospitals: prevalence analysis 2010-2017]. Rev Med Chile. 2019;147(4):416-25. Spanish. https://doi.org/10.4067/S0034-98872019000400416
Waller P, Shaw M, Ho D, Shakir S, Ebrahim S. Hospital admissions for ‘drug-induced’ disorders in England: a study using the Hospital Episodes Statistics (HES) database. Br J Clin Pharmacol. 2005;59(2):213-9. https://doi.org/10.1111/j.1365-2125.2004.02236.x
Parikh S, Christensen D, Stuchbery P, Peterson J, Hutchinson A, Jackson T. Exploring in-hospital adverse drug events using ICD-10 codes. Aust Health Rev. 2014;38(4):454-60. https://doi.org/10.1071/AH13166
Tamma PD, Avdic E, Li DX, Dzintars K, Cosgrove SE. Association of adverse events with antibiotic use in hospitalized patients. JAMA Intern Med. 2017;177(9):1308-15. https://doi.org/10.1001/jamainternmed.2017.1938
Carrasco-Garrido P, Andrés LA, Hernámdez Barrera V, Miguel GA, Jiménez-García R. Trends of adverse drug reactions related-hospitalizations in Spain (2001-2006). BMC Health Serv Res. 2010;10:287. https://doi.org/10.1186/1472-6963-10-287
Scripcaru G, Mateus C, Nunes C. Adverse drug events: analysis of a decade. A Portuguese case-study, from 2004 to 2013 using hospital database. PLoS One. 2017;12(6):e0178626. https://doi.org/10.1371/journal.pone.0178626
Mekonnen AB, Alhawassi TM, McLachlan AJ, Brien JE. Adverse drug events and medication errors in African hospitals: a systematic review. Drugs Real World Outcomes. 2018;5(1):1-24. https://doi.org/10.1007/s40801-017-0125-6
Chan EW, Liu KQL, Chui CSL, Sing CW, Wong LYL, Wong ICK. Adverse drug reactions – examples of detection of rare events using databases. Br J Clin Pharmacol. 2015;80(4):855-61. https://doi.org/10.1111/bcp.12474
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Copyright (c) 2022 Lunara Teles Silva, Ana Carolina Figueiredo Modesto, Rodrigo Alves de Oliveira, Rita Goreti Amaral, Flavio Marques Lopes
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
