Characteristics of Drug-RElated Hospitalizations for Nursing HOme Residents: Cross-Sectional RENHO Study

Alice Lopez, Chiara Alfarano, Marianne Lepetit, Leila Chebane, Nassima Redjimi, Anaïs Couret, Didier Fabre, Virginie Gardette, Driss Berdaï, Maryse Lapeyre-Mestre and Haleh Bagheri ()
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Alice Lopez: Toulouse University Hospital
Chiara Alfarano: Toulouse University Hospital
Marianne Lepetit: Toulouse University Hospital
Leila Chebane: Toulouse University Hospital
Nassima Redjimi: Toulouse University Hospital
Anaïs Couret: Toulouse University Hospital
Didier Fabre: Toulouse University Hospital (CHU Toulouse)
Virginie Gardette: Toulouse University Hospital
Driss Berdaï: Bordeaux University Hospital
Maryse Lapeyre-Mestre: Toulouse University Hospital
Haleh Bagheri: Toulouse University Hospital

Drug Safety, 2025, vol. 48, issue 9, No 7, 1047-1061

Abstract: Abstract Background Nursing home residents with advancing age are often exposed to polypharmacy, a well-known risk factor for adverse drug reactions (ADRs), which increases the risk of hospitalization. Therefore, we assessed the characteristics of and factors associated with ADR-related emergency department (ED) admissions among nursing home residents. Methods We carried out a cross-sectional study using the Toulouse University Hospital discharge database to identify nursing home residents ED admissions from 1 April, 2019 to 31 March, 2020. Information was updated for 2 years after inclusion (re-admissions). Emergency department medical files were analyzed to identify factors associated with these admissions (including demographics, functional dependency level, comorbidities, body mass index, ED admission in the previous 12 previous months, and number of drugs). Results We identified 1514 patients (corresponding to 2024 ED admissions), 409 of whom (27.0%) were admitted at least once for an ADR. Thirty-six nursing home residents were re-admitted in 2020 and/or 2021 for ADRs, half of whom were for the same ADR. The most frequent ADRs were falls (114, 24.3%), hemorrhagic events (106, 22.6%), and constipation (47, 10.0%) involving benzodiazepines and Z-drugs (170, 16.0%), antidepressants (125, 11.9%), antithrombotic drugs (110, 10.3%), and opioids (82, 7.7%). About 12% of ADRs were assessed as avoidable. Factors significantly associated with ADR-related ED admissions were the number of drugs (odds ratio 1.09; 95% confidence interval 1.05–1.13), previous ED admissions (odds ratio 3.47; 95% confidence interval 2.46–4.90), and overweight (odds ratio 1.54; confidence interval 1.15–2.06). Conclusions Drug-induced iatrogenic disease could lead to ED admission for nursing home residents in approximately one-quarter of cases, 12% of which were assessed as avoidable. A previous history of ED admission and polypharmacy remain key associated factors. The awareness-raising campaigns for health professionals should be strengthened to prevent avoidable drug-induced ADRs.

Date: 2025
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DOI: 10.1007/s40264-025-01556-3

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