December 2012 to March 2013 were registered by clinical phar- macist. The
admissions caused by an ADR, the type of reactions and the suspected drugs
were ...
2013 ACCP Annual Meeting October 13–16, 2013 Albuquerque, New Mexico (Pharmacotherapy 2013;33(10)e182-e299) ORIGINAL RESEARCH ADR/Drug Interactions 1. Adverse drug reaction related hospitalizations in a Chinese hospital: a prospective study. Man Zhu, Master1, Zhihui Tang, Master2, Daihong Guo, Master2, Dongxiao Wang, Master2, Weilan Wang, Master2, Fei Pei, Master2; (1) Department of Pharmaceutical Care, Chinese PLA General Hospital, Beijing, China (2) Chinese PLA General Hospital, Beijing, China BACKGROUND: Adverse Drug Reactions (ADRs) have been regarded as a major public health problem since they represent a sizable percentage of admissions. Unfortunately, there are few data on epidemiology of ADR related admissions in China. PURPOSE: The study undertook a prospective analysis to evaluate the frequency, the adverse reactions and the main suspected drugs of ADRs related admissions and provide data for safe drug use. METHODS: Age, sex, duration, drugs taken before admission, diagnoses, renal and liver function, alcohol abuse and allergic history of all patients admitted in four wards in our hospital from December 2012 to March 2013 were registered by clinical pharmacist. The admissions caused by an ADR, the type of reactions and the suspected drugs were also registered. RESULTS: A total of 1001 consecutive adult patients admitted to the hospital during a 16-week period. Thirty-six patients (3.6%) were hospitalized for ADRs related causes, among which, Oncology (21/379), Enocrineology (10/312), Cardiology (2/185) and Pheumology (3/89). Hypoglycemia, myelosuppression, hypoleukemia were the frequent ADRs, with antidiabetics (7/36) and antitumor drugs (21/ 36) as the main suspected drugs. Male patients admitted due to ADRs were significantly more than female patients (p18 or >89 year, pregnant women, prisoners, and those with congenital factor VII deficiency. Data collected includes demographics, laboratory data, indication for use, history of thrombosis, hematolog-
ic studies, transfusions, use of anticoagulant or hemostatic agents, cumulative dosage, evidence of ischemia or thromboembolism, and all cause 30-day mortality. Statistical analysis was performed by fisher’s exact test for nominal data and Mann-Whitney U test for non-parametric continuous data and presented as median (25–75% interquartile range). RESULTS: One hundred and eighty-five were identified for inclusion and 14.9% (27) patients experienced TEC with 70.4% (19) being arterial and 29.6% (8) venous. There were no differences in demographics, median cumulative dosage rFVIIa administered (37.4 [22–79] versus 45 [21–131] mcg/kg, p=0.42), and concurrent use of anticoagulant or hemostatic agents between those who developed a TEC and those who did not. There was a trend for increased all cause 30-day mortality in those who experienced a TEC (51.9% versus 36.1%, p=0.14). CONCLUSION: Administration of rFVIIa in non-hemophiliacs may lead to an increased development of TECs particularly arterial TECs. Further prospective studies are needed to determine whether total dosage used increases risk.
Adult Medicine 3. Asymptomatic bacteriuria in adult acute care patients: a descriptive analysis. Ryan Dull, Pharm.D.1, Stacey Friedman, Pharm.D.2, Meghan Doyle, Pharm.D. Candidate2, Brianne Davis, Pharm.D. Candidate2; (1) Department of Pharmacy Practice, Creighton University School of Pharmacy and Health Professions, Omaha, NE (2) Creighton University School of Pharmacy and Health Professions, Omaha, NE PURPOSE: Asymptomatic bacteriuria (ABU) is a common finding in hospitalized adults. Despite the lack of benefit, many patients with ABU receive antimicrobials. The goal of this research project was to assess those patients admitted to a community hospital with evidence of ABU and treated with antimicrobials. METHODS: Adult patients admitted to our community hospital (157 beds) with bacteriuria obtained within 24 hours of admission between June 2011 and March 2012 were reviewed. ABU was defined as bacteriuria without documented urinary symptoms. Patients were considered symptomatic if urinary urgency or frequency, dysuria, suprapubic tenderness, flank pain, rigors, or gross hematuria were documented in the electronic medical record. Excluded patients were pediatrics (1.2 mg/dL or creatinine clearance 0.05) and mean number of encounters (0.02 0.08 and 0.06 0.11, respectively; p>0.05) were not significantly different for the intervention group relative to the control group (n=100). CONCLUSIONS: Results demonstrate no significant impact of the policy on outcomes related to health condition management for this subpopulation of Medicaid beneficiaries. Nonetheless, this study demonstrates practice application for mixed model trajectory analysis, which takes the individual into account when evaluating the outcome as a whole. Further studies are needed to investigate the impact of this policy; specifically, an analysis of cost and analysis of changes in health care professional workload. 13. Assessing time to failure of maintain blood pressure goals in patients with diabetes discharged from a Veterans Affairs Medical Center (VAMC) pharmacist-managed primary care clinic. Golden Peters, Pharm.D., BCPS, P. Benjamin Erwin, Pharm.D., BCACP, Matthew Pitlick, Pharm.D., BCPS; Saint Louis College of Pharmacy, Saint Louis, MO PURPOSE: This study evaluated the ability of patients with diabetes mellitus type II (T2DM) to maintain goal systolic blood pressure (SBP) of
