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Repeat Adverse Drug Reaction-Related Hospital Admissions in Elderly Australians: A Retrospective Study at the Royal Hobart Hospital

Nair, N, Chalmers, L, Bereznicki, BJ ORCID: 0000-0001-8463-4817, Curtain, CM ORCID: 0000-0001-5029-7541 and Bereznicki, LR ORCID: 0000-0003-3974-3437 2017 , 'Repeat Adverse Drug Reaction-Related Hospital Admissions in Elderly Australians: A Retrospective Study at the Royal Hobart Hospital' , Drugs & aging, vol. 34, no. 10 , doi: 10.1007/s40266-017-0490-6.

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Abstract

Background: Adverse drug reactions are a major cause ofhospital admissions in older individuals, with the majoritypotentially preventable. Despite the apparent magnitude ofthis problem, little is known about rates of repeat admissionto hospital as a result of adverse drug reactions.Objectives: The objectives of this study were to investigatethe occurrence of repeat adverse drug reaction-relatedhospital admissions in elderly patients within 12 months ofan adverse drug reaction-related admission to a medicalward and whether a validated adverse drug reaction scorecould be useful in identifying patients at higher risk of arepeat adverse drug reaction-related hospitalisation.Methods: This retrospective study followed elderly participantswho were hospitalised with an adverse drug reactionfrom our earlier study [the PADR-EC (Prediction ofHospitalization due to Adverse Drug Reactions in ElderlyCommunity-Dwelling Patients) study] to identify repeatadverse drug reaction-related hospital admissions within12 months of discharge. The PADR-EC score is the sum ofpoints assigned to five significant predictors of adversedrug reaction-related hospitalisation: antihypertensive use,renal failure, dementia, inappropriate anticholinergic useand drug changes in the preceding 3 months. The causality,preventability and severity of each adverse drug reactionrelatedrepeat admission within the 12-month follow-upwere assessed.Results: Adverse drug reaction-related repeat admissionsoccurred after 13.4% (n= 15) of 112 adverse drug reaction-relatedindex admissions. Patients with a repeatadverse drug reaction-related admission had significantlyhigher PADR-EC scores at discharge of their indexadmission (median PADR-EC score 7, interquartile range7–9) than patients who were not readmitted (medianPADR-EC score 7, interquartile range 5–7, p = 0.034).Most (73.3%) adverse drug reaction-related repeat admissionswere considered ‘preventable’. Adverse drug reactionseverity was ‘moderate’ in all cases. Renal disorders(44.4%) represented the most common adverse drug reactionsand the most frequently implicated drug classes werediuretics (44.8%). All adverse drug reaction-related repeatadmissions were found to be ‘probable’.Conclusions: One in eight elderly patients hospitalisedbecause of an adverse drug reaction had a repeat admissionfor an adverse drug reaction within 12 months of discharge.The PADR-EC score could potentially be used athospital discharge to prioritise patients for interventions toprevent subsequent adverse drug reaction-related hospitaladmissions.

Item Type: Article
Authors/Creators:Nair, N and Chalmers, L and Bereznicki, BJ and Curtain, CM and Bereznicki, LR
Keywords: ADR, elderly, repeat admission
Journal or Publication Title: Drugs & aging
Publisher: Adis International Ltd
ISSN: 1170-229X
DOI / ID Number: 10.1007/s40266-017-0490-6
Copyright Information:

Copyright 2017 Springer International Publishing AG

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