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Assessing risk of adverse drug reactions in the elderly: a feasibility study

Ridge, A, Macintyre, K ORCID: 0000-0003-2741-0467, Kitsos, A ORCID: 0000-0003-4319-1559, Murray, L and Bereznicki, L ORCID: 0000-0003-3974-3437 2019 , 'Assessing risk of adverse drug reactions in the elderly: a feasibility study' , International journal of clinical pharmacy , pp. 1-8 , doi:

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Background: Adverse drug reactions are common in Australian general practice and can be a cause of, or contribute to,preventable hospital admissions. Developing practical tools to assist in identifying patients who are at high risk of serious adverse drug reactions is an important step in preventing these hospitalisations. Objective: The aims of the study wereto apply the Prediction of Hospitalisation due to Adverse Drug Reactions in Elderly Community-Dwelling Patients (PADREC) Score to assess the risk of medication-related hospitalisation among patients aged ≥65 years attending a rural generalpractice, and to investigate general practitioners’ acceptance of the PADR-EC Score. Setting: The project was based in amulticentre rural general practice in southern Tasmania, Australia. Method: We conducted a cross-sectional study whereinthe PADR-EC score was administered to patients aged ≥65 years attending a general practice. A focus group of generalpractice doctors was conducted and thematic analysis of the transcript used to explore their views regarding the utility ofthe PADR-EC score. Main Outcome Measures: Successful application of the PADR-EC Score and an evaluation of generalpractitioners’ acceptance of the PADR-EC Score are the two outcome measures of the project. Results: The PADR-EC scorewas applied by the practice pharmacist and reported to GPs for 428 patients aged ≥65 years, with 24.8% classifed as highrisk. The focus group found the PADR-EC score helped raise awareness of the risk of adverse drug reactions in the generalpractice setting. Doctors demonstrated good understanding of the PADR-EC Score and there were no negative reactions tothe delivery model used. No changes to prescribing were implemented directly as a result of the PADR-EC Score, but morecaution was used when doctors provided their usual clinical care. Conclusion: Doctors used the PADR-EC score to complement their decision making. The PADR-EC Score was used as a reminder to review existing medication lists, follow-upon pathology results that may impact drug treatment and assess patients for prevalent ADRs. Further research is needed tovalidate the PADR-EC score in this setting.

Item Type: Article
Authors/Creators:Ridge, A and Macintyre, K and Kitsos, A and Murray, L and Bereznicki, L
Keywords: adverse drug reaction, general practice, risk, elderly, safety
Journal or Publication Title: International journal of clinical pharmacy
Publisher: Springer
ISSN: 2210-7703
DOI / ID Number:
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Copyright 2019 Springer Nature Switzerland AG

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