C. Lacoste-roussillon et al., Incidence of serious adverse drug reactions in general practice: A prospective study, CLIN PHARM, 69(6), 2001, pp. 458-462
Background: Many studies have been conducted to estimate the incidence and
economic impact of adverse drug reactions. Most of these studies used histo
rical data or were based on single hospital units. Little is known, however
, about the frequency of serious adverse drug reactions in general practice
.
Objective: To estimate the incidence of serious adverse drug reactions in t
he community.
Methods: A prospective study during 5 consecutive working days between Marc
h 1 and April 30, 1998, was conducted among a random representative sample
of 254 general practitioners in Aquitaine, France. The main outcome measure
was the number of serious adverse drug reactions tie, resulting in death,
life threatening condition, hospitalization, incapacity, or sequel) observe
d by each general practitioner during the study period and validated by an
expert panel.
Results: Thirteen validated serious adverse drug reactions, 2 of which were
fatal (1 subarachnoidal hemorrhage with oral anticoagulant and 1 aplastic
anemia with antineoplastics), were observed, resulting in an incidence dens
ity of 10.2 (95% confidence interval [CI], 5.4 to 17.5) per 1000 days of pr
actice. Eleven case subjects (84.6%) were hospitalized. This represents an
average of 2.6 cases per general practitioner per year, and 123,000 adverse
drug reaction cases (95% CI, 65,400 to 210,000) for the 60,000 general pra
ctitioners in France. Antineoplastics and anticoagulants were the drugs mos
t frequently involved, and blood dyscrasia and bleeding were the most frequ
ent adverse drug reactions.
Conclusion: This study, which is one of the few available that has prospect
ively measured the incidence of serious adverse drug reactions in general p
ractice settings, confirms that serious adverse drug reactions are a major
public health concern.