Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan;9(1):13-23.
doi: 10.1177/2042098617736191. Epub 2017 Oct 24.

Incident adverse drug reactions in geriatric inpatients: a multicentred observational study

Amanda Lavan  1 , Joseph Eustace  1 , Darren Dahly  2 , Evelyn Flanagan  3 , Paul Gallagher  1 , Shane Cullinane  4 , Mirko Petrovic  5 , Katrina Perehudoff  6 , Adalsteinn Gudmondsson  7 , Ólafur Samuelsson  7 , Ástrós Sverrisdóttir  7 , Antonio Cherubin  8 , Frederica Dimitri  8 , Joe Rimland  8 , Alfonso Cruz-Jentoft  9 , Manuel Vélez-Díaz-Pallarés  9 , Isabel Lozano Montoya  10 , Roy L Soiza  11 , Selvarani Subbarayan  12 , Denis O'Mahony  13
Affiliations

Incident adverse drug reactions in geriatric inpatients: a multicentred observational study

Amanda Lavan et al. Ther Adv Drug Saf. 2018 Jan.

Abstract

Background: Adverse drug reactions (ADRs) are common in older adults and frequently have serious clinical and economic consequences. This study was conducted as a feasibility study for a randomized control trial (RCT) that will investigate the efficacy of a software engine to optimize medications and reduce incident (in-hospital) ADRs. This study's objectives were to (i) establish current incident ADR rates across the six sites participating in the forthcoming RCT and (ii) assess whether incident ADRs are predictable.

Methods: This was a multicentre, prospective observational study involving six European hospitals. Adults aged ⩾ 65 years, hospitalized with an acute illness and on pharmacological treatment for three or more conditions were eligible for inclusion. Adverse events (AEs) were captured using a trigger list of 12 common ADRs. An AE was deemed an ADR when its association with an administered drug was adjudicated as being probable/certain, according to the World Health Organization Uppsala Monitoring Centre causality assessment. The proportion of patients experiencing at least one, probable/certain, incident ADR within 14 days of enrolment/discharge was recorded.

Results: A total of 644 patients were recruited, evenly split by sex and overwhelmingly of White ethnicity. Over 80% of admissions were medical. The median number of chronic conditions was five (interquartile range 4-6), with eight or more conditions present in approximately 10%. The mean number of prescribed medications was 9.9 (standard deviation 3.8), which correlated strongly with the number of conditions (r = 0.54, p < 0.0001). A total of 732 AEs were recorded in 382 patients, of which 363 were incident. The majority of events were classified as probably or possibly drug related, with heterogeneity across sites (χ2 = 88.567, df = 20, p value < 0.001). Out of 644 patients, 139 (21.6%; 95% confidence interval 18.5-25.0%) experienced an ADR. Serum electrolyte abnormalities were the most common ADR. The ADRROP (ADR Risk in Older People) and GerontoNet ADR risk scales correctly predicted ADR occurrence in 61% and 60% of patients, respectively.

Conclusion: This feasibility study established the rates of incident ADRs across the six study sites. The ADR predictive power of ADRROP and GerontoNet ADR risk scales were limited in this population.

Keywords: adverse drug reactions (ADRs); adverse events (AEs); hospitalized; incidence; multimorbidity; older adults.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

References

    1. Kongkaew C, Noyce PR, Ashcroft DM. Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. Ann Pharmacother 2008; 42: 1017–1025. - PubMed
    1. Hamilton H, Gallagher P, Ryan C, et al. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients. Arch Intern Med 2011; 171: 1013–1019. - PubMed
    1. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 1998; 279: 1200–1205. - PubMed
    1. O’Connor MN, O’Sullivan D, Gallagher PF, et al. Prevention of hospital-acquired adverse drug reactions in older people using screening tool of older persons’ prescriptions and screening tool to alert to right treatment criteria: a cluster randomized controlled trial. J Am Geriatr Soc 2016; 64: 1558–1566. - PubMed
    1. Cooper JW. Probable adverse drug reactions in a rural geriatric nursing home population: a four-year study. J Am Geriatr Soc 1996; 44: 194–197. - PubMed