Adverse Drug Events and Contributing Factors among Hospitalized Adult Patients at Jimma Medical Center, South West Ethiopia: A Prospective Observational Study

Abstract

Background: Adverse drug events are an important source of morbidity and mortality in different clinical settings of different countries. It causes a negative impact on patient‟s health status that leads to a major impact on expenditure of healthcare systems. Knowledge of the incidence, type, and preventability of adverse drug events is core to develop prevention strategy; as a result to improve the quality of health care delivery and relevant to minimize the expenditure of health care cost. Objective: To assess burden of adverse drug events and contributing factors among hospitalized adult patients at Jimma Medical Center. Methods: A prospective observational study was conducted. Data was collected from all patients admitted from April 15 to July 15, 2019 at medical ward and who fulfilled the inclusion criteria. Data was checked for consistency and analyzed using statistical software package, SPSS version 24. Statistical significance was considered at p-value <0.05. Results: A total of 319 patients with 5667 person-days were followed. One hundred sixteen adverse drug events were identified with incidence of 36.36 (95% CI 30.05- 43.61) per 100 admissions (crude rate), 20.47 (95% CI 16.91- 24.55) per 1000 person days and 8.32 (95% CI 6.87- 9.97) per 100 medication orders. Causality were 26.72% definite, 60.34% probable, 12.93% possible ADEs. Regarding the severity, 37.07% mild, 52.59% moderate and 10.34% were severe ADEs. Most (62.07%) of ADEs were definitely/probably preventable. Anti TB agents, disease of circulatory system, disease of digestive system, being on medication during admission and length of hospital stay ≥15 days were independent predictors of the occurrence of ADEs. A total of 94 potential ADEs were identified with incidence of 29.47 (95% CI 23.8- 36.06) per 100 admissions (crude rate), 16.59 (95% CI 13.55- 20.3) per 1000 person days and 6.74 (95% CI 5.45- 8.25) per 100 medication orders. Number of medications ≥7, antiviral agents, anti-seizures, anti TB agents and anticoagulants were independent predictors of potential ADEs. Conclusion: The incidence of ADEs identified in this study was consistent with published data. One in every four patients admitted in the ward experienced ADEs during their hospital stay and about two out of three cases were judged as either moderate or severe. About two third of the identified ADEs were deemed probably or definitely preventable. Recommendations: Close monitoring and multidisciplinary communication on use of high-risk medications such as anti TB, antiviral agents, anti-seizures and anticoagulants.