Assessment of the Severity, Preventability and Causality of Adverse Drug Reactions in Shortand Medium-Stay Psychiatric Inpatient

• Published in: Drug safety Vol. 44; no. 12; p. 1442
• Main Authors: Martin, S, Philipot, M G, Lepoix, E, Trenque, T, Pascali, P
• Format: Journal Article
• Language: English
• Published: Auckland Springer Nature B.V 01.12.2021
• Subjects: Antipsychotics; Asthenia; Benzodiazepines; Causality; Central nervous system; Diazepam; Drugs; Extrapyramidal system; Medical records; Patients; Side effects
• ISSN: 0114-5916; 1179-1942

Background/Introduction: Psychiatric hospitalization, in short and medium-stay units, consists of the overall care of patients in the acute phase to stabilize them and improve their condition to allow their discharge and outpatient care. Objective/Aim: In this study, we evaluated the causality, severity and preventability of adverse drug reactions (ADRs) mentioned in the medical records of this population of hospitalized patients. Methods: A retrospective observational study was conducted among hospitalized patients on the 24th of November, 2020, in short- and medium-stay units in our psychiatric hospital. The medical records of each patient were analyzed to identify ADRs that occurred during their hospitalization. For each ADR identified, severity was assessed using the Hartwig scale, preventability was assessed using the French Olivier scale and causality was assessed using the French Arimone method. Results: Of the 180 patients in our study group, 72 had at least one ADR (median age = 51 years, range 15-85; women: 56%; prescribed drugs = 9 ± 3.5). 149 ADRs were identified: 99.3% were mild or moderate in severity and only one was severe. 87.9% of ADRs were unavoidable and 12.1% were potentially preventable. 85.9% of the ADRs identified were described in the Summary of Product Characteristics of the incriminated molecules. The most common ADRs were sedation/somnolence (35%), asthenia (8.7%) and extrapyramidal syndrome (7.4%). Loxapine (18.1%), diazepam (12.2%) and cyamemazine (8%) were the most involved drugs in the occurrence of ADRs. Conclusion: The most suspected molecules of causing ADRs have been the neuroleptics and have predominantly affected the central nervous system. This work provides an opportunity to educate medical staff on the appropriate use and monitoring of psychiatric medications to prevent the potential occurrence of ADRs.