Drug-related hospital admissions

The association between hospital admissions and drug-related problems was studied in 216 patients. All patients admitted to a general 100-bed ward in a large teaching hospital over a two-month period were interviewed by the pharmacist to determine (1) prescription and nonprescription drugs regularly administered by the patient, (2) method of administration, (3) patients' compliance with prescribed therapy, and (4) signs and symptoms of adverse drug reactions. Fifty-nine (27.3%) patients were found to have a drug-related problem associated with their hospital admission. Twenty-four patients (11.1%) had an adverse drug reaction associated with their hospital admission; in only 17 (7.9%) of the patients did the adverse reaction cause the hospital admission. Adverse drug reactions and noncompliance (10.5%) appeared to be the principal factors in hospital admission. To a lesser extent, inadequate therapy, improper or erroneous drug use and drug overdose were found to be associated with hospital admissions. As to mechanism of drug reaction, a drug side effect was involved in most cases. While hospital pharmacists have traditionally concentrated on improving inpatient distribution services, this study indicates a need for the improvement of drug monitoring and education services available to patients in outpatient settings.