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

Nibu Parameswaran Nair (), Leanne Chalmers, Bonnie J. Bereznicki, Colin Curtain, Gregory M. Peterson, Michael Connolly and Luke R. Bereznicki
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Nibu Parameswaran Nair: University of Tasmania
Leanne Chalmers: University of Tasmania
Bonnie J. Bereznicki: University of Tasmania
Colin Curtain: University of Tasmania
Gregory M. Peterson: University of Tasmania
Michael Connolly: University of Tasmania
Luke R. Bereznicki: University of Tasmania

Drug Safety, 2017, vol. 40, issue 7, No 6, 597-606

Abstract: Abstract 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.

Keywords: Adverse Drug Reaction; Clinical Pharmacist; Medication Reconciliation; Unplanned Admission; Naranjo Algorithm (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (3)

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DOI: 10.1007/s40264-017-0528-z

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