Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Am Geriatr Soc. 2012 Jan;60(1):34-41. doi: 10.1111/j.1532-5415.2011.03772.x. Epub 2011 Dec 8.

Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans.

Author information

  • 1Departments of Geriatrics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15213, USA. zam12@pitt.edu

Abstract

OBJECTIVES:

To describe the prevalence of unplanned hospitalizations caused by adverse drug reactions (ADRs) in older veterans and to examine the association between this outcome and polypharmacy after controlling for comorbidities and other patient characteristics.

DESIGN:

Retrospective cohort.

SETTING:

Veterans Affairs Medical Centers.

PARTICIPANTS:

Six hundred seventy-eight randomly selected unplanned hospitalizations of older (aged ≥ 65) veterans between October 1, 2003, and September 30, 2006.

MEASUREMENTS:

Naranjo ADR algorithm, ADR preventability, and polypharmacy (0-4, 5-8, and ≥9 scheduled medications).

RESULTS:

Seventy ADRs involving 113 drugs were found in 68 (10%) hospitalizations of older veterans, of which 25 (36.8%) were preventable. Extrapolating to the population of more than 2.4 million older veterans receiving care during the study period, 8,000 hospitalizations may have been unnecessary. The most common ADRs that occurred were bradycardia (n = 6; beta-blockers, digoxin), hypoglycemia (n = 6; sulfonylureas, insulin), falls (n = 6; antidepressants, angiotensin-converting enzyme inhibitors), and mental status changes (n = 6; anticonvulsants, benzodiazepines). Overall, 44.8% of veterans took nine or more outpatient medications and 35.4% took five to eight. Using multivariable logistic regression and controlling for demographic, health-status, and access-to-care variables, polypharmacy (≥9 and 5-8) was associated with greater risk of ADR-related hospitalization (adjusted odds ratio (AOR) = 3.90, 95% confidence interval (CI) = 1.43-10.61 and AOR = 2.85, 95% CI = 1.03-7.85, respectively).

CONCLUSION:

ADRs, determined using a validated causality algorithm, are a common cause of unplanned hospitalization in older veterans, are frequently preventable, and are associated with polypharmacy.

© 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

PMID:
22150441
[PubMed - indexed for MEDLINE]
PMCID:
PMC3258324
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Blackwell Publishing Icon for PubMed Central
    Loading ...
    Write to the Help Desk