Parameswaran Nair, N and Chalmers, L and Bereznicki, BJ and Curtain, C and Peterson, GM and Connolly, M and Bereznicki, LR, Adverse drug reaction-related hospitalizations in elderly Australians: A prospective cross-sectional study in two Tasmanian hospitals, Drug Safety, 40, (7) pp. 597-606. ISSN 0114-5916 (2017) [Refereed Article]
Copyright 2017 Springer International Publishing Switzerland
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.
|Item Type:||Refereed Article|
|Keywords:||ADR, elderly, prevention, adverse drug reaction, clinical pharmacist, medication, reconciliation, unplanned admission, Naranjo algorithm|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Pharmacology and pharmaceutical sciences|
|Research Field:||Clinical pharmacy and pharmacy practice|
|Objective Group:||Other health|
|Objective Field:||Other health not elsewhere classified|
|UTAS Author:||Parameswaran Nair, N (Dr Nibu Parameswaran Nair)|
|UTAS Author:||Chalmers, L (Dr Leanne Chalmers)|
|UTAS Author:||Bereznicki, BJ (Dr Bonnie Bereznicki)|
|UTAS Author:||Curtain, C (Mr Colin Curtain)|
|UTAS Author:||Peterson, GM (Professor Gregory Peterson)|
|UTAS Author:||Connolly, M (Mr Michael Connolly)|
|UTAS Author:||Bereznicki, LR (Professor Luke Bereznicki)|
|Web of Science® Times Cited:||24|
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