L. Letrilliart et al., Postdischarge adverse drug reactions in primary care originating from hospital care in France - A nationwide prospective study, DRUG SAFETY, 24(10), 2001, pp. 781-792
Objective: To describe and estimate the incidence and preventability of pos
tdischarge adverse drug reactions (ADRs) detected in primary care in France
.
Design: Prospective study of patients referred to hospital by participating
general practitioners (GPs). These GPs reported all cases of an adverse re
action to a drug instituted in hospital among patients who consulted them w
ithin 30 days of discharge.
Setting: 305 general practices from all French regions.
Patients: 7540 patients referred by GPs to private or public hospitals.
Main outcome measures: The incidence for postdischarge ADRs in primary care
, and their preventability.
Results: 30 cases of postdischarge ADR were detected in 29 re-consulting pa
tients, yielding a minimal incidence for France of 0.4 per 100 admissions (
95% confidence interval 0.3 to 0.6). The ADRs were assessed as serious in 6
0% of cases. The main drug classes implicated were cardiovascular drugs (8
ADRs), oral anticoagulants (6), psychoactive drugs (4), antidiabetics (3),
and opioid analgesics (3). Patients experiencing a postdischarge ADR were o
lder than patients not experiencing one (median age: 77 vs 68 years; p = 0.
004). Detected ADRs were considered preventable in 59% of cases.
Conclusions: Physicians and patients should be aware of the possible occurr
ence of postdischarge ADRs. Patient information in hospital, close postdisc
harge follow-up of patients at risk, and appropriate transmission of inform
ation between hospital physicians and GPs can help to prevent them.