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【drug-news】JAMA发布的关于药物不良反应的研究报
Date: October 22, 2006
Large Number Of Adverse Drug Events Lead To Emergency Department Visits
Each year, an estimated 700,000 persons experience adverse drug events that lead to emergency department visits, according to a study in the October 18 issue of JAMA.
Outpatient use of drug therapies in the United States is common. In 2004, 82 percent of the U.S. population reported using at least 1 prescription medication, over-the-counter medication, or dietary supplement in the previous week and 30 percent reported using 5 or more of these drugs, according to background information in the article. While these medications may offer substantial benefits, there also may be risks. Information on outpatient adverse drug events (ADEs) has been difficult to collect, but the problem is large and can be expected to increase.
Daniel S. Budnitz, M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues analyzed data from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project (NEISS-CADES) to determine the frequency and characteristics of ADEs in the U.S. that have led to emergency department visits. The study included data from Jan. 2004 through Dec. 2005.
Over the 2-year study period, 21,298 adverse drug event cases were reported. "Based on data from a nationally representative surveillance system, we estimate that more than 700,000 patients were treated for ADEs in U.S. emergency departments annually in 2004 and 2005, and 1 of every 6 required subsequent hospital admission, transfer to another health care facility, or emergency department observation admission. Individuals aged 65 years or older were more than twice as likely to be treated in emergency departments for an ADE and nearly 7 times as likely to require hospitalization as individuals younger than 65 years. Among all patients who were hospitalized, most ADEs were due to unintentional overdoses and two-thirds of these were due to toxicity from a relatively small set of drugs for which regular monitoring is commonly required to prevent acute toxicity. Sixteen of the 18 drugs most commonly causing ADEs have been in clinical use for more than 20 years," the authors write.
Adverse drug events accounted for 2.5 percent of estimated emergency department visits for all unintentional injuries and 6.7 percent of those leading to hospitalization, and also accounted for 0.6 percent of estimated emergency department visits for all causes.
Insulins or warfarin, drugs that typically require ongoing monitoring to prevent overdose or toxicity, were implicated in 1 in every 7 estimated ADEs treated in emergency departments.
"The finding that individuals aged 65 years or older (12 percent of the U.S. population) accounted for one-quarter of ADEs overall and half of adverse events requiring hospitalization highlights the importance of directing ADE prevention efforts to this vulnerable population. Emergency department visits for ADEs in this age group were nearly as common as those for motor vehicle occupant injuries," the authors write.
"Efforts to reduce the burden of outpatient ADEs have been hampered by sparse data, except in selected health care systems or settings. Ongoing data collection in NEISS-CADES will enable more detailed examination of the epidemiology of emergency department-treated outpatient ADEs, focusing on specific patient populations, drug classes, conditions, and circumstances. Identifying appropriate measures of drug exposure and evaluating drug risks in relation to drug benefits remain important challenges in improving the quality of outpatient drug therapy," the researchers write. 大量的药物不良反应事件需要患者急诊治疗
据JAMA10月18日的报道称，每年，估计有七十万人因药物不良反应事件去急诊看病。
药物治疗在美国是相当普遍的，按照该篇报道提供的背景信息显示，在2004年，有82%的美国人在接受调查的前一周正在使用至少1种处方药、OTC药或者正在进行食疗，有30%的人使用了5种或5种以上的药物。诚然，这些药品能提供治疗作用，但是药三分毒。非住院病人出现药物不良反应（ADEs）是个严重问题，而且还有上升地趋势，但要收集这方面信息是很困难。
亚特兰大疾病预防控制中心的Daniel博士和他的同事通过分析国家电子创伤监测系统联合药物不良反应监测工程（NEISS-CADES）的数据，来研究美国ADEs的性质和发生频次。研究范围自2004年1月到2005年12月。
在两年的时间里，药物不良反应报道有21298例。在文章中作者写道，“通过这些国家权威检测系统的数据，在2004到2005年间，我们估计有超过700000的病人因不良反应不得不去就医。其中每6个人里有1人需要入院治疗，转院或者在急诊留观。个别年龄为65岁或更大的患者甚至因同一种不良反应去急诊就医超过两次，他们需要住院的人数是65岁以下人群的近7倍之多。在住院的病人中大部分的药物不良反应都是由于误服过量药物引起，有2/3是因为毒性反应。而这些引起中毒的药物又通常是那些为避免用药引起急性毒性而需要定期监控的的小剂量包装药物，这样的药物18个里有16种是在临床已使用了超过20年的品种。”
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作者:admin@医学,生命科学 2011-06-27 17:44
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