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Preventing adverse drug reactions after hospital discharge (PADR-AD): Protocol for a randomised-controlled trial in older people


Cousins, J and Parameswaran Nair, N and Curtain, C and Bereznicki, B and Wilson, K and Adamczewski, B and Barratt, A and Webber, L and Simpson, T and McKenzie, D and Connolly, M and Bereznicki, L, Preventing adverse drug reactions after hospital discharge (PADR-AD): Protocol for a randomised-controlled trial in older people, Research in Social and Administrative Pharmacy ISSN 1934-8150 (2021) [Refereed Article]

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2021 Elsevier Inc. All rights reserved.

DOI: doi:10.1016/j.sapharm.2021.09.007


Background: Adverse drug reactions (ADRs) and adverse drug events (ADEs) in older people contribute to a significant proportion of hospital admissions and are common following discharge. Effective interventions are therefore required to combat the growing burden of preventable ADRs. The Prediction of Hospitalisation due to Adverse Drug Reactions in Elderly Community Dwelling Patients (PADR-EC) score is a validated risk score developed to assess the risk of ADRs in people aged 65 years and older and has the potential to be utilised as part of an intervention to reduce ADRs.

Objectives: This trial was designed to investigate the effectiveness of an intervention to reduce ADR incidence in older people and to obtain further information about ADRs and ADEs in the 12-24 months following hospital discharge.

Methods: The study is an open-label randomised-controlled trial to be conducted at the Royal Hobart Hospital, a 500-bed public hospital in Tasmania, Australia. Community-dwelling patients aged 65 years and older with an unplanned overnight admission to a general medical ward will be recruited. Following admission, the PADR-EC ADR score will be calculated by a research pharmacist, with the risk communicated to clinicians and discussed with participants. Following discharge, nominated general practitioners and community pharmacists will receive the risk score and related medication management advice to guide their ongoing care of the patient. Follow-up with participants will occur at 3 and 12 and 18 and 24 months to identify ADRs and ADEs. The primary outcome is moderate-severe ADRs at 12 months post-discharge, and will be analysed using the cumulative incidence proportion, survival analysis and Poisson regression.

Summary: It is hypothesised that the trial will reduce ADRs and ADEs in the intervention population. The study will also provide valuable data on post-discharge ADRs and ADEs up to 24 months post-discharge.

Item Details

Item Type:Refereed Article
Keywords:adverse drug reactions, adverse drug events, older people, hospital discharge, transitional care
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Cousins, J (Mr Justin Cousins)
UTAS Author:Parameswaran Nair, N (Dr Nibu Parameswaran Nair)
UTAS Author:Curtain, C (Mr Colin Curtain)
UTAS Author:Bereznicki, B (Dr Bonnie Bereznicki)
UTAS Author:Wilson, K (Miss Kiara Wilson)
UTAS Author:Bereznicki, L (Professor Luke Bereznicki)
ID Code:146866
Year Published:2021
Web of Science® Times Cited:1
Deposited By:Pharmacy
Deposited On:2021-09-30
Last Modified:2021-12-09
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