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Drug Saf. 2017 Jul;40(7):597-606. doi: 10.1007/s40264-017-0528-z.

Adverse Drug Reaction-Related Hospitalizations in Elderly Australians: A Prospective Cross-Sectional Study in Two Tasmanian Hospitals.

Author information

1
Unit for Medication Outcomes Research and Education, Division of Pharmacy, Faculty of Health, School of Medicine, University of Tasmania, Hobart, TAS, 7001, Australia. Nibu.ParameswaranNair@utas.edu.au.
2
Unit for Medication Outcomes Research and Education, Division of Pharmacy, Faculty of Health, School of Medicine, University of Tasmania, Hobart, TAS, 7001, Australia.
3
Royal Hobart Hospital, Hobart, TAS, Australia.

Abstract

INTRODUCTION:

Adverse drug reactions (ADRs) have been commonly cited as a major cause of hospital admissions in older individuals. However, despite the apparent magnitude of this problem, there are limited prospective data on ADRs as a cause of hospitalization in elderly medical patients.

OBJECTIVES:

The objective of this study was to evaluate the proportion, clinical characteristics, causality, severity, preventability, and outcome of ADR-related admissions in older patients admitted to two Tasmanian hospitals.

METHODS:

We conducted a prospective cross-sectional study at the Royal Hobart and Launceston General Hospitals in Tasmania, Australia. A convenience sample of patients, aged 65 years and older, undergoing unplanned overnight medical admissions was screened. ADR-related admissions were determined through expert consensus from detailed review of medical records and patient interviews. The causality, preventability and severity of each ADR-related admission were assessed.

RESULTS:

Of 1008 admissions, the proportion of potential ADR-related medical admissions was 18.9%. Most (88.5%) ADR-related admissions were considered preventable. Cardiovascular complaints (29.3%) represented the most common ADRs, followed by neuropsychiatric (20.0%) and renal and genitourinary disorders (15.2%). The most frequently implicated drug classes were diuretics (23.9%), agents acting on the renin angiotensin system (16.4%), β-blocking agents (7.1%), antidepressants (6.9%), and antithrombotic agents (6.9%). Application of the Naranjo algorithm found 5.8% definite, 70.1% probable, and 24.1% possible ADRs. ADR severity was rated moderate and severe in 97.9% and 2.1% of admissions, respectively. For most (93.2%) ADR-related admissions the ADR resolved and the patient recovered.

CONCLUSION:

Hospitalization due to an ADR is a common occurrence in this older population. There is need for future studies to implement and evaluate interventions to reduce the risk of ADR-related admissions in elderly populations.

PMID:
28382494
DOI:
10.1007/s40264-017-0528-z
[Indexed for MEDLINE]

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