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Prospective identification versus administrative coding of adverse drug reaction‐related hospitalizations in the elderly: A comparative analysis

Parameswaran Nair, N ORCID: 0000-0002-0202-6453, Chalmers, L, Peterson, GM ORCID: 0000-0002-6764-3882, Bereznicki, BJ ORCID: 0000-0001-8463-4817, Curtain, CM ORCID: 0000-0001-5029-7541 and Bereznicki, LR ORCID: 0000-0003-3974-3437 2018 , 'Prospective identification versus administrative coding of adverse drug reaction‐related hospitalizations in the elderly: A comparative analysis' , Pharmacoepidemiology and Drug Safety, vol. 27, no. 11 , 1281–1285 , doi:

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Purpose: To compare prospective identification of adverse drug reaction (ADR)‐relatedhospital admissions in the elderly with administrative coding using the International Classificationof Diseases 10th Revision Australian Modification (ICD‐10‐AM) coding system.Methods: We linked the records of 768 enrolled patients from an earlier study,where clinical pharmacists identified ADRs using prospective data collection, to hospitaladministrative data. We identified patients in the study whose admissions werecoded as ADRs using ICD‐10‐AM codes. We then compared the prevalence and characteristicsof ADR‐related hospital admissions identified by the two approaches.Results: According to ICD‐10‐AM coding, 2.7% of patients were admitted due toADRs, while 15.0% of patients were deemed to have been admitted due to ADRs basedon prospective identification by clinical pharmacists. Most (85.7%) patients coded ashaving an ADR‐related hospital admission were also identified as such prospectively.Hematological (23.1%) and metabolic reactions (23.1%) were frequent causes of ADRsidentified by coding, whereas cardiovascular ADRs (27.8%) were more common causesof ADRs identified prospectively by pharmacists. Antidepressants (16.7%) and cardiacglycosides (16.7%) were the most commonly implicated drug groups in ADRs identifiedby coding, whereas diuretics (28.8%) and renin‐angiotensin system inhibitors (17.0%)were frequently implicated as causes of ADRs identified prospectively by pharmacists.Conclusions: Reliance on administrative coding potentially underestimates theextent of the problem of ADRs as a cause of hospitalization in the elderly, and moredetailed prospective analysis of admissions provides additional targets for strategiesto prevent ADRs. The types of ADRs identified also differ between the two approaches.

Item Type: Article
Authors/Creators:Parameswaran Nair, N and Chalmers, L and Peterson, GM and Bereznicki, BJ and Curtain, CM and Bereznicki, LR
Keywords: adverse drug reactions, coding, elderly, hospital admissions, pharmacoepidemiology
Journal or Publication Title: Pharmacoepidemiology and Drug Safety
Publisher: John Wiley & Sons Ltd
ISSN: 1053-8569
DOI / ID Number:
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Copyright 2018 John Wiley & Sons, Ltd.

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