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

Nair, NP, Chalmers, L, Bereznicki, BJ ORCID: 0000-0001-8463-4817, Curtain, C ORCID: 0000-0001-5029-7541, Peterson, GM ORCID: 0000-0002-6764-3882, Connolly, M and Bereznicki, LR ORCID: 0000-0003-3974-3437 2017 , 'Adverse Drug Reaction-Related Hospitalizations in Elderly Australians: A Prospective Cross-Sectional Study in Two Tasmanian Hospitals' , Drug Safety, vol. 40, no. 7 , pp. 597-606 , doi: 10.1007/s40264-017-0528-z.

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Abstract

Introduction: Adverse drug reactions (ADRs) have beencommonly cited as a major cause of hospital admissions inolder individuals. However, despite the apparent magnitudeof this problem, there are limited prospective data onADRs as a cause of hospitalization in elderly medicalpatients.Objectives: The objective of this study was to evaluate theproportion, clinical characteristics, causality, severity,preventability, and outcome of ADR-related admissions inolder patients admitted to two Tasmanian hospitals.Methods: We conducted a prospective cross-sectional studyat the Royal Hobart and Launceston General Hospitals inTasmania, Australia. A convenience sample of patients,aged 65 years and older, undergoing unplanned overnightmedical admissions was screened. ADR-related admissionswere determined through expert consensus from detailedreview of medical records and patient interviews. Thecausality, preventability and severity of each ADR-relatedadmission were assessed.Results: Of 1008 admissions, the proportion of potentialADR-related medical admissions was 18.9%. Most(88.5%) ADR-related admissions were consideredpreventable. Cardiovascular complaints (29.3%) representedthe most common ADRs, followed by neuropsychiatric(20.0%) and renal and genitourinary disorders(15.2%). The most frequently implicated drug classes werediuretics (23.9%), agents acting on the renin angiotensinsystem (16.4%), b-blocking agents (7.1%), antidepressants(6.9%), and antithrombotic agents (6.9%). Application ofthe Naranjo algorithm found 5.8% definite, 70.1% probable,and 24.1% possible ADRs. ADR severity was ratedmoderate and severe in 97.9% and 2.1% of admissions,respectively. For most (93.2%) ADR-related admissionsthe ADR resolved and the patient recovered.Conclusion: Hospitalization due to an ADR is a commonoccurrence in this older population. There is need for futurestudies to implement and evaluate interventions to reducethe risk of ADR-related admissions in elderly populations.

Item Type: Article
Authors/Creators:Nair, NP and Chalmers, L and Bereznicki, BJ and Curtain, C and Peterson, GM and Connolly, M and Bereznicki, LR
Keywords: ADR, elderly, prevention
Journal or Publication Title: Drug Safety
Publisher: Adis International Ltd
ISSN: 0114-5916
DOI / ID Number: 10.1007/s40264-017-0528-z
Copyright Information:

Copyright 2017 Springer International Publishing Switzerland

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