Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Am Geriatr Soc. 2013 Nov;61(11):1894-9. doi: 10.1111/jgs.12504. Epub 2013 Oct 1.

Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications.

Author information

  • 1MCPHS University, Worcester, Massachusetts; Meyers Primary Care Institute, Worcester, Massachusetts; University of Massachusetts Medical School, Worcester, Massachusetts.

Abstract

OBJECTIVES:

To characterize adverse drug events (ADEs) occurring within the high-risk 45-day period after hospitalization in older adults.

DESIGN:

Clinical pharmacists reviewed the ambulatory records of 1,000 consecutive discharges.

SETTING:

A large multispecialty group practice closely aligned with a Massachusetts-based health plan.

PARTICIPANTS:

Hospitalized individuals aged 65 and older discharged home.

MEASUREMENTS:

Possible drug-related incidents occurring during the 45-day period after hospitalization were identified and presented to a pair of physician-reviewers who classified incidents as to whether an ADE was present, whether the event was preventable, and the severity of the event. Medications implicated in ADEs were further characterized according to their inclusion in the 2012 Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.

RESULTS:

At least one ADE was identified during the 45-day period in 18.7% (n = 187) of the 1,000 discharges. Of the 242 ADEs identified, 35% (n = 84) were deemed preventable, of which 32% (n = 27) were characterized as serious, and 5% (n = 4) as life threatening. More than half of all ADEs occurred within the first 14 days after hospitalization. The percentage of ADEs in which Beers Criteria medications were implicated was 16.5% (n = 40). Beers criteria medications with both a high quality of evidence and strong strength of recommendation were implicated in 6.6% (n = 16) of the ADEs.

CONCLUSION:

ADEs are common and often preventable in older adults after hospital discharge, underscoring the need to address medication safety during this high-risk period in this vulnerable population. Beers criteria medications played a small role in these events, suggesting that efforts to improve the quality and safety of medication use during this critical transition period must extend beyond a singular focus on Beers criteria medications.

© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

KEYWORDS:

Beers medications; adverse drug events; ambulatory care setting; older adults

PMID:
24116689
[PubMed - indexed for MEDLINE]
PMCID:
PMC4446728
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley Icon for PubMed Central
    Loading ...
    Write to the Help Desk