Premium
Hospitalisation and morbidity due to adverse drug reactions in elderly patients: a single‐centre study
Author(s) -
Ognibene Silvia,
Vazzatale,
Giumelli Claudio,
Savoldi Luisa,
Braglia Luca,
Chesi Giuseppe
Publication year - 2018
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.13961
Subject(s) - medicine , polypharmacy , observational study , adverse effect , retrospective cohort study , confidence interval , pediatrics , drug reaction , emergency medicine , pharmacoepidemiology , drug , medical prescription , pharmacology
Background Adverse drug reaction (ADR) is a leading but under‐recognised cause of illness, particularly in frail subjects with multiple comorbidities. Aim To investigate the frequency, patterns and outcomes of ADR as a cause of hospitalisation in elderly patients admitted to an internal medicine ward. Methods We performed a retrospective observational study including every patient aged over 65 years who was admitted to our department during a 12‐month period. Patients admitted to short‐stay (<24 h) observation unit were excluded. Results ADR accounted for 106 of total 1750 recorded admissions, which constituted a proportion of 6.1% (95% confidence interval 5.0–7.3%). The median age of patients was 83.5 (78.0–87.0) years and 56.6% were on polypharmacy. A total of 170 ADR was recorded with 45.3% of subjects experiencing concomitantly more than one ADR from a single molecule. Diuretics were the most commonly imputed molecules (30 events, 17.6%), followed by antithrombotics (25 events, 14.7%) and central nervous system‐active drugs (16 events, 9.4%). Interactions were judged responsible for 39 cases of ADR (36.8%). An unfavourable outcome was observed in about one‐third of patients (37.7%). Among those subjects, 11 (10.4%) died and 29 (27.4%) had residual disability. Conclusion ADR are a common cause of hospital admission in elderly patients and are often associated with adverse outcomes. Our data underline the need of appropriate strategies aimed at identifying high‐risk patients and avoiding potentially preventable drug toxicities.