Adverse drug reactions (ADR) account for 5 to 7% of emergency department (ED) consultations. We aimed to assess medication risk profiles for ADRs leading to ED visits.
We analysed medication intake and patient demographics in a prospective multi-centre observational study collecting ADR cases in four large EDs in Germany. Odds ratios (OR) were calculated to relate drug classes taken to those suspicious for an ADR after a causality assessment.
A total of 2215 cases of ED visits due to ADRs were collected. The median age of the cohort was 73 years; in median, six co-morbidities and an intake of seven drugs were documented. Antineoplastic/immunomodulating agents had the highest OR for being suspected for an ADR (OR 20.45, 95% CI 14.54–28.77), followed by antithrombotics (OR 2.94, 95% CI 2.49–3.47), antibiotics (OR 2.65, 95% CI 1.78–3.95), systemic glucocorticoids (OR 2.43, 95% CI 1.54–3.82) and drugs affecting the central nervous system (CNS), such as antipsychotics (OR 2.36, 95% CI 1.46–3.81), antidepressants (OR 2.10, 95% CI 1.57–2.83), antiparkinsonian medication (OR 2.11, 95% CI 1.15–3.84), opioids (OR 1.79, 95% CI 1.26–2.54) and non-opioid analgesics (OR 1.32, 95% CI 1.01–1.72).
Patients experiencing ADRs leading to ED visits are commonly old, multi-morbid and multi-medicated. CNS drugs may be more relevant than prior expected. With calculating ORs, we could replicate involvement of antineoplastic agents, antithrombotics, antibiotics, systemic glucocorticoids and non-opioid analgesics as frequently suspected for ADRs in EDs.
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The datasets analysed during the current study are available from the corresponding author on reasonable request.
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The study trial is registered at the German Clinical Trial Register (DRKS-ID: DRKS00008979).
The ADRED-study has received financial funding within the framework of the AMTS focus of the German Federal Ministry of Health (BMG), grant number ZMVI5–2514ATA004. M.S. and S.I. are in part supported by the Robert Bosch Foundation, Stuttgart, Germany.
The authors declare that they have no competing interests.
The study was approved by the responsible ethical committee of the University of Bonn (202/15) and reviewed positively by the respective ethical committees of the study centres of the Universities of Erlangen-Nürnberg (43_16Bc), Tübingen (113/16) and Ulm (493/2016BO1).
Informed consent was obtained from individual participants included in the study described in the manuscript.
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Just, K.S., Dormann, H., Böhme, M. et al. Personalising drug safety—results from the multi-centre prospective observational study on Adverse Drug Reactions in Emergency Departments (ADRED). Eur J Clin Pharmacol 76, 439–448 (2020). https://doi.org/10.1007/s00228-019-02797-9
- Adverse drug reaction
- Drug safety
- Emergency department
- Drug class
- Older adults