Methods and systems to detect adverse drug reactions in hospitals

Detection of adverse drug reactions (ADRs) in hospitals offers the chance t o detect serious ADRs resulting in hospitalisation and ADRs occurring in ho spitalised patients, i.e. patients with high comorbidity and receiving drug s that are administered only in hospitals. The most commonly applied method s involve stimulated spontaneous reporting of doctors and nurses, comprehen sive collection by trained specialists and, more recently, computer-assiste d approaches using routine data from hospital information systems. The diff erent methods of ADR detection used result in different rates and types of ADRs and, consequently, in different drug classes being responsible for the se ADRs. Another factor influencing the results of surveys is the interpret ation of the term ADR, where some authors adhere to the strict definition o f the World Health Organization and many others include intended and uninte nded poisoning as well as errors in prescribing and dispensing, thus referr ing to adverse drug events. Depending on the method used for screening of p atients, a high number of possible ADRs and only few definite ADRs are foun d, or vice versa. These variations have to be taken into account when compa ring the results of further analyses performed with these data. ADR rates a nd incidences in relation to the number of drugs prescribed or patients exp osed have been calculated in only a few surveys and projects, and this inte resting pharmacoepidemiological approach deserves further study. In additio n, the pharmacoeconomic impact of ADRs, either resulting in hospitalisation or prolonging hospital stay, has been estimated using different approaches . However, a common standardised procedure for such calculations has not ye t been defined. Although detection of ADRs in hospitals offers the opportun ity to detect severe ADRs of newly approved drugs, these ADRs are still dis covered by spontaneous reporting systems. The prospects offered by electron ic hospital information systems as well as implementation of pharmacoepidem iological approaches increases the possibilities and the value of ADR detec tion in hospitals.