Persistence of Adverse Drug Reaction-Related Hospitalization Risk Following Discharge

Area of Science:

• Pharmacovigilance and Patient Safety
• Clinical Epidemiology
• Health Services Research

Background:

• Adverse drug reactions (ADRs) are a significant cause of hospital admissions.
• Understanding the long-term readmission risk following an ADR-related admission is crucial for patient safety.
• Previous studies have not fully elucidated the duration and magnitude of this increased risk.

Purpose of the Study:

• To assess the risk of hospital admission due to adverse drug reactions (ADRs) after discharge.
• To compare readmission risks between patients with index ADR-related admissions and non-ADR-related admissions.
• To identify risk factors for ADR-related re-hospitalization.

Main Methods:

• Retrospective cohort study of 91,500 adult patients admitted to public hospitals in Tasmania, Australia (2011-2015).
• Analysis of administrative hospital records with follow-up until May 2017.
• Survival analysis and propensity score matching were used to assess ADR-related readmission risk and logistic regression identified risk factors.

Main Results:

• Patients with an ADR-related index admission were nearly five times more likely to have another ADR-related admission within 90 days (p < 0.001).
• This elevated risk persisted for at least 5 years (p < 0.001).
• In a matched subset, ADR-related admissions more than doubled within 90 and 365 days (p < 0.0001), often involving the same drug class.

Conclusions:

• An ADR-related index admission substantially increases the risk of future ADR-related hospitalizations, a risk that is longer-lasting than previously recognized.
• Cancer, heart failure, and increasing age are significant risk factors for ADR-related re-hospitalization within 90 days.
• These findings underscore the importance of vigilant monitoring and preventative strategies for patients with a history of ADRs.