{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:27:26Z","timestamp":1790108846699,"version":"4.0.1"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can J Hosp Pharm"],"abstract":"<jats:p>Background: Drug-induced liver injury (DILI) is an important but underdiagnosed adverse drug reaction in hospitalized patients. The complexity of diagnosis, under-reporting, and a lack of standardized assessment tools contribute to underestimation of its prevalence.\nObjectives: To estimate the prevalence of DILI in a tertiary care hospital and to discuss the role of clinical pharmacists in using the Roussel Uclaf Causality Assessment Method (RUCAM) to detect, assess, and manage DILI.\nMethods: This cross-sectional study included patients who were admitted between January and June 2022 to a tertiary care hospital in Porto Alegre, Brazil. All hospitalized patients with alanine aminotransferase (ALT) levels at least 3 times the upper limit of normal at any point during the hospital stay were screened. Suspected cases of DILI were evaluated by trained pharmacists using the RUCAM. Data were collected retrospectively from electronic medical records and analyzed using descriptive and inferential statistics.\nResults: Of 56 014 patients admitted to the hospital during the study period, 1274 had elevated ALT, of whom 38 were classified by the RUCAM as having DILI. Among these, 33 (87%) experienced development of DILI during the hospital stay. Most of the patients (n = 29, 76%) were in general hospital wards, and this factor showed a significant association with occurrence of DILI. Anti-infectives were the most commonly implicated drugs (69%), specifically the combination of rifampicin, isoniazid, pyrazinamide, and ethambutol and various \u03b2-lactams. Simvastatin was also commonly implicated. None of the DILI cases were reported to the institutional pharmacovigilance system.\nConclusions: DILI remains under-recognized and under-reported in hospital settings. This study reinforces the potential role of clinical pharmacists in active surveillance using RUCAM and highlights the need for institutional strategies prioritizing the monitoring of liver function in high-risk patients, particularly on general wards.\nKeywords: drug-induced liver injury, hospital pharmacy, patient safety, pharmacovigilance\nR\u00c9SUM\u00c9\nContexte : La l\u00e9sion h\u00e9patique d\u2019origine m\u00e9dicamenteuse (LHOM) est une r\u00e9action ind\u00e9sirable importante, mais souvent sous-diagnostiqu\u00e9e chez les patients hospitalis\u00e9s. La complexit\u00e9 du diagnostic, la sous d\u00e9claration des cas et le manque d\u2019outils d\u2019\u00e9valuation standardis\u00e9s contribuent \u00e0 la sous-estimation de sa pr\u00e9valence.\nObjectifs : Estimer la pr\u00e9valence de la LHOM dans un h\u00f4pital de soins tertiaires et discuter du r\u00f4le des pharmaciens cliniciens dans la d\u00e9tection, l\u2019\u00e9valuation et la prise en charge de la LHOM \u00e0 l\u2019aide de la m\u00e9thode d\u2019\u00e9valuation de la causalit\u00e9 Roussel Uclaf (\u00e9chelle RUCAM).\nM\u00e9thodologie : Cette \u00e9tude transversale comprenait des patients admis de janvier \u00e0 juin 2022 dans un \u00e9tablissement de soins tertiaires \u00e0 Porto Alegre, au Br\u00e9sil. Tous les patients hospitalis\u00e9s dont le taux d\u2019alanine aminotransf\u00e9rase (ALT) \u00e9tait sup\u00e9rieur ou \u00e9gal \u00e0 trois fois la limite sup\u00e9rieure de la normale \u00e0 un moment quelconque de l\u2019hospitalisation ont \u00e9t\u00e9 s\u00e9lectionn\u00e9s. Les cas suspects de LHOM ont \u00e9t\u00e9 \u00e9valu\u00e9s \u00e0 l\u2019aide de l\u2019\u00e9chelle RUCAM par des pharmaciens form\u00e9s. Les donn\u00e9es ont \u00e9t\u00e9 recueillies r\u00e9trospectivement \u00e0 partir des dossiers m\u00e9dicaux \u00e9lectroniques et analys\u00e9es \u00e0 l\u2019aide de statistiques descriptives et inf\u00e9rentielles.\nR\u00e9sultats : Sur les 56 014 patients admis \u00e0 l\u2019h\u00f4pital pendant la p\u00e9riode de l\u2019\u00e9tude, les taux d\u2019ALT de 1274 patients \u00e9taient \u00e9lev\u00e9s, dont 38 qui ont \u00e9t\u00e9 class\u00e9s comme ayant une LHOM selon l\u2019\u00e9chelle RUCAM. Parmi ceux-ci, 33 patients (87 %) ont d\u00e9velopp\u00e9 une LHOM au cours de leur s\u00e9jour. La majorit\u00e9 des patients (n = 29, 76 %) se trouvaient dans des unit\u00e9s d\u2019hospitalisation g\u00e9n\u00e9rale. Ce facteur a d\u00e9montr\u00e9 une association significative avec la survenue de la LHOM. Les m\u00e9dicaments anti-infectieux \u00e9taient les plus fr\u00e9quemment associ\u00e9s \u00e0 cette derni\u00e8re (69 %), en particulier la combinaison rifampicine, isoniazide, pyrazinamide et \u00e9thambutol, ainsi que divers \u03b2-lactamines. La simvastatine y \u00e9tait, elle aussi, fr\u00e9quemment associ\u00e9e. Aucun des cas de LHOM n\u2019a \u00e9t\u00e9 signal\u00e9 au syst\u00e8me institutionnel de pharmacovigilance.\nConclusions : La LHOM demeure sous-reconnue et sous-d\u00e9clar\u00e9e en milieu hospitalier. Cette \u00e9tude renforce le r\u00f4le potentiel des pharmaciens cliniciens dans la surveillance active \u00e0 l\u2019aide de l\u2019\u00e9chelle RUCAM et souligne la n\u00e9cessit\u00e9 de strat\u00e9gies institutionnelles visant \u00e0 prioriser le suivi de la fonction h\u00e9patique chez les patients \u00e0 haut risque, en particulier dans les unit\u00e9s d\u2019hospitalisation g\u00e9n\u00e9rales.\nMots-cl\u00e9s : l\u00e9sion h\u00e9patique d\u2019origine m\u00e9dicamenteuse, pharmacie d\u2019h\u00f4pital, s\u00e9curit\u00e9 du patient, pharmacovigilance<\/jats:p>","DOI":"10.4212\/cjhp.3827","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T17:27:17Z","timestamp":1762968437000},"source":"Crossref","is-referenced-by-count":1,"title":["Pharmacist-Led Assessment of Drug-Induced Liver Injury in Hospitalized Patients"],"prefix":"10.4212","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7895-5742","authenticated-orcid":false,"given":"Gabriela","family":"Xavier Ortiz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3271-2566","authenticated-orcid":false,"given":"Karin","family":"Hepp Schwambach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6910-8210","authenticated-orcid":false,"given":"Ana Helena","family":"Dias Pereira dos Santos Ulbrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2410-3536","authenticated-orcid":false,"given":"Henrique","family":"Dias Pereira dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0190-3688","authenticated-orcid":false,"given":"Matheus","family":"William Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5935-1196","authenticated-orcid":false,"given":"Carine","family":"Raquel Blatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2732","published-online":{"date-parts":[[2025,11,12]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3827\/5760","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3827\/5766","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3827\/5760","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T17:27:17Z","timestamp":1762968437000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3827"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,11,12]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3827","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"value":"1920-2903","type":"electronic"},{"value":"0008-4123","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11,12]]},"article-number":"e3827"}}