Risk factors for drug-related problems in a general hospital: A large prospective cohort

• DOI: 10.1371/journal.pone.0230215
• Publication Date: 2020-05-05T17:35:58Z
• Authors: Valdjane Saldanha; Ivonete Batista d...; Sara Iasmin Vieir...; Rand Randall Martins; Antonio Gouveia O...
• Keywords: Adult; Male; Drug-Related Side Effects and Adverse Reactions; Science; Q; R; Middle Aged; Hospitals, General; 3. Good health; Hospitalization; Tertiary Care Centers; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Pharmaceutical Services; Medicine; Electronic Health Records; Humans; Female; Hospital Mortality; Brazil; Research Article; Aged

Objective To identify risk factors for potential Drug-Related Problems (DRP) at admission in hospitalized patients. Methodology Prospective cohort study conducted adults patients (May 2016 to May 2018) a general tertiary care hospital Brazil. Potential DRP were detected by daily review of 100% electronic medication orders pharmacists and classified the Pharmaceutical Care Network Europe classification system (PCNE version 6.2). For identification DRP, backward stepwise logistic regression was used set independent predictors among over 120 variables collected initial 48 hours after training consisting 2/3 population. The model validated remaining sample. Results population consisted 1686 aged 52.0+/- 18.3 years-old, 51.4% females, with median length stay 3.24 days, 4.5% in-hospital mortality. cumulative incidence 14.5%. Admission elective surgery main diagnosis disease circulatory associated reduced (OR 0.41 0.57, respectively, p<0.05). are heart rate ≥ 80 bpm 1.41, p = 0.05), prescription more than seven drugs day 2 1.63, 1 Anatomical Therapeutic Chemical Code (ATC) class A (alimentary tract metabolism, OR 2.24, 0.003), two or ATC 3.52, p<0.001), J (antiinfectives systemic use, 1.97, 0.001). In validation set, c-statistic predictive 0.65, sensitivity 56.1% specificity 65.2%. Conclusion This identified that have fair performance utilization clinical practice.