Certain Drug Classes Linked to More ED Visits for Adverse Drug Reactions

A study published in JAMA reports that anticoagulants, antibiotics, diabetes drugs, and opioids are the most common drug classes related to emergency department visits for adverse drug events in the country. 

Researchers from the Centers for Disease Control and Prevention (CDC) studied the characteristics of emergency department visits for adverse drug events in 2013–2014 and changes in emergency department visits for adverse drug events since 2005–2006. They analyzed data from 58 emergency departments as part of the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project.

After reviewing data from 42,585 cases, researchers estimated four visits to the emergency department for adverse drug events per 1,000 individuals per year in 2013 and 2014. Of the total visits, 27% resulted in hospitalization. There was an increase in emergency department visits due to adverse drug events among adults aged ≥65 years in 2013–2014 (44%) vs. 2005–2006 (26%). Researchers noted that older adults generally had the highest hospitalization rates (44%).  

Nearly half (47%) of the emergency department visits for adverse drug events involved anticoagulants, antibiotics, and diabetes drugs; clinically significant adverse events included hemorrhage, moderate to severe allergic reactions, and hypoglycemia with moderate to severe neurological effects. 

The proportion of emergency department visits for adverse drug events involving anticoagulants and diabetes drugs has increased since 2005–2006 whereas the proportion of visits due to antibiotics has decreased. 

When stratified by age, antibiotics were most commonly implicated in children aged ≤5 years (56%); for children and adolescents 6–19 years, antibiotics (32%) and antipsychotics (4.5%) were associated with emergency department visits. 

Anticoagulants, diabetes drugs, and opioids were implicated in ~60% of emergency department visits for adverse drug events among older adults (≥65 years). Specifically, warfarin, rivaroxaban, dabigatran, enoxaparin, insulin, and four oral antidiabetic agents were among the 15 most common drugs. 

The study authors added that addressing adverse drug events that are more common in specific patient populations “may help further focus outpatient medication safety efforts.”

For more information visit JAMAmedia.org.