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

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A Letter to the Editor to this article was published on 15 November 2017

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.

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Correspondence to Nibu Parameswaran Nair.

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Funding

No sources of funding were used to assist in the preparation of this study.

Conflict of interest

Luke R. Bereznicki reports receiving personal fees for the provision of expert advice from Boehringer Ingelheim Pty Ltd outside this study. Nibu Parameswaran Nair, Leanne Chalmers, Bonnie J. Bereznicki, Colin Curtain, Gregory M. Peterson, and Michael Connolly declare that they have no conflicts of interest that are directly relevant to the content of this study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval for the study was obtained from the Tasmanian Health and Medical Human Research Ethics Committee of the University of Tasmania and informed consent was obtained from all individual participants included in the study.

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Parameswaran Nair, N., Chalmers, L., Bereznicki, B.J. et al. Adverse Drug Reaction-Related Hospitalizations in Elderly Australians: A Prospective Cross-Sectional Study in Two Tasmanian Hospitals. Drug Saf 40, 597–606 (2017). https://doi.org/10.1007/s40264-017-0528-z

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