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

Author

Listed:
  • 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
    Royal Hobart Hospital)

  • Luke R. Bereznicki

    (University of Tasmania)

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.

Suggested Citation

  • Nibu Parameswaran Nair & Leanne Chalmers & Bonnie J. Bereznicki & Colin Curtain & Gregory M. Peterson & Michael Connolly & Luke R. Bereznicki, 2017. "Adverse Drug Reaction-Related Hospitalizations in Elderly Australians: A Prospective Cross-Sectional Study in Two Tasmanian Hospitals," Drug Safety, Springer, vol. 40(7), pages 597-606, July.
    • Handle: RePEc:spr:drugsa:v:40:y:2017:i:7:d:10.1007_s40264-017-0528-z
    DOI: 10.1007/s40264-017-0528-z
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    Cited by:

    1. Renly Lim & Lisa M. Kalisch Ellett & Susan Semple & Elizabeth E. Roughead, 2022. "The Extent of Medication-Related Hospital Admissions in Australia: A Review from 1988 to 2021," Drug Safety, Springer, vol. 45(3), pages 249-257, March.
    2. Olive Schmid & Bonnie Bereznicki & Gregory Mark Peterson & Jim Stankovich & Luke Bereznicki, 2022. "Persistence of Adverse Drug Reaction-Related Hospitalization Risk Following Discharge," IJERPH, MDPI, vol. 19(9), pages 1-12, May.
    3. Mona Kargar & Alireza Ahmadvand & Kheirollah Gholami, 2018. "Comment on: “Adverse Drug Reaction-Related Hospitalizations in Elderly Australians: A Prospective Cross-Sectional Study in Two Tasmanian Hospitals”," Drug Safety, Springer, vol. 41(3), pages 321-322, March.

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