Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence

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dc.contributor.authorMouton, Johannes P.en_ZA
dc.contributor.authorJobanputra, Nicoleen_ZA
dc.contributor.authorNjuguna, Christineen_ZA
dc.contributor.authorGunter, Hannahen_ZA
dc.contributor.authorStewart, Annemieen_ZA
dc.contributor.authorMehta, Ushmaen_ZA
dc.contributor.authorLahri, Saaden_ZA
dc.contributor.authorCourt, Richarden_ZA
dc.contributor.authorIgumbor, Ehimarioen_ZA
dc.contributor.authorMaartens, Garyen_ZA
dc.contributor.authorCohen, Karenen_ZA
dc.date.accessioned2022-01-26T12:23:56Z
dc.date.available2022-01-26T12:23:56Z
dc.date.issued2021
dc.descriptionCITATION: Mouton, J. P., et al. 2021. Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence. African Journal of Emergency Medicine, 11(1):46-52, doi:10.1016/j.afjem.2020.10.010.
dc.descriptionThe original publication is available at https://www.sciencedirect.com/journal/african-journal-of-emergency-medicine
dc.description.abstractIntroduction: South Africa has the world’s largest antiretroviral treatment programme, which may contribute to the adverse drug reaction (ADR) burden. We aimed to determine the proportion of adult non-trauma emergency unit (EU) presentations attributable to ADRs and to characterise ADR-related EU presentations, stratified according to HIV status, to determine the contribution of drugs used in management of HIV and its complications to ADR-related EU presentations, and identify factors associated with ADR-related EU presentation. Methods: We conducted a retrospective folder review on a random 1.7% sample of presentations over a 12-month period in 2014/2015 to the EUs of two hospitals in Cape Town, South Africa. We identified potential ADRs with the help of a trigger tool. A multidisciplinary panel assessed potential ADRs for causality, severity, and preventability. Results: We included 1010 EU presentations and assessed 80/1010 (7.9%) as ADR-related, including 20/239 (8.4%) presentations among HIV-positive attendees. Among HIV-positive EU attendees with ADRs 17/20 (85%) were admitted, versus 22/60 (37%) of HIV-negative/unknown EU attendees. Only 5/21 (24%) ADRs in HIVpositive EU attendees were preventable, versus 24/63 (38%) in HIV-negative/unknown EU attendees. On multivariate analysis, only increasing drug count was associated with ADR-related EU presentation (adjusted odds ratio 1.10 per additional drug, 95% confidence interval 1.03 to 1.18), adjusted for age, sex, HIV status, comorbidity, and hospital. Conclusions: ADRs caused a significant proportion of EU presentations, similar to findings from other resourcelimited settings. The spectrum of ADR manifestations in our EUs reflects South Africa’s colliding epidemics of infectious and non-communicable diseases. ADRs among HIV-positive EU attendees were more severe and less likely to be preventable.en_ZA
dc.description.urihttps://www.sciencedirect.com/science/article/pii/S2211419X20301269?via%3Dihub
dc.description.versionPublisher’s version
dc.format.extent7 pages
dc.identifier.citationMouton, J. P., et al. 2021. Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence. African Journal of Emergency Medicine, 11(1):46-52, doi:10.1016/j.afjem.2020.10.010
dc.identifier.issn2211-419X (online)
dc.identifier.otherdoi:10.1016/j.afjem.2020.10.010
dc.identifier.urihttp://hdl.handle.net/10019.1/124145
dc.language.isoen_ZAen_ZA
dc.publisherElsevier
dc.rights.holderAuthors retain copyright
dc.subjectDrugs -- Side effectsen_ZA
dc.subjectEmergency medicineen_ZA
dc.subjectHIV infections -- Complicationsen_ZA
dc.titleAdult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalenceen_ZA
dc.typeArticleen_ZA
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