Adverse drug reaction risk factors in older outpatients

Hajjar, Emily R.; Hanlon, Joseph T.; Artz, Margaret B.; Lindblad, Catherine I.; Pieper, Carl F.; Sloane, Richard; Ruby, Christine M.; Schmader, Kenneth E.

doi:10.1016/s1543-5946(03)90004-3

Cited by 150 publications

(93 citation statements)

References 25 publications

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“…This increase in life expectancy has brought about increased numbers of certain chronic illnesses, which involves hospital admissions, multiple medications and its associated ADR's [3]. Inappropriate use of medicines is one of the challenges of the public health domain and may lead to serious (ADRs) [4]that account for 3% to 23% of hospital admissions, prolong hospital stays, and increase in morbidity and mortality [5].…”

Section: Introductionmentioning

confidence: 99%

Effects of Polypharmacy on Adverse Drug Reactions among Geriatric outpatients at a Tertiary Care Hospital in Karachi, A prospective cohort study.

Ahmed

Nanji

Patel

2015

International Journal of Epidemiology

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Background: Adverse drug reactions (ADRs) present a challenging and expensive public health problem. Polypharmacy is defined according to the WHO criteria as the, ''concurrent use of five or more different prescription medication''. Elderly are more prone to adverse reactions due to comorbid conditions, longer lists of medications and sensitivity to drug effects. The aim of the study is to estimate the incidence and strength of association of ADRs due to polypharmacy among the geriatric cohort attending outpatient clinics at a tertiary care center.

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Section: Introductionmentioning

confidence: 99%

Effects of Polypharmacy on Adverse Drug Reactions among Geriatric outpatients at a Tertiary Care Hospital in Karachi, A prospective cohort study.

Ahmed

Nanji

Patel

2015

International Journal of Epidemiology

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“…DRPs arise because of the increasing number of medications required by this age group, fragmented systems of care, pre-existing health conditions, and the pharmacokinetic and pharmacodynamic changes that occur with aging (Bigos, Bies, & Pollock, 2006;Cusack, 2004;Gurwitz, 2004;Hajjar et al, 2003;Turnheim, 2004Turnheim, , 2005. Avoiding use of high-risk drugs is an important strategy in reducing DRPs.…”

Section: Introductionmentioning

confidence: 99%

Health outcomes associated with potentially inappropriate medication use in older adults

Fick

Mion

Beers

et al. 2007

Research in Nursing & Health

256

198

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The purpose of this study was to examine the prevalence of potentially inappropriate medication use (PIMs) among community-dwelling older adults and the association between PIMs and health care outcomes. Participants were 17,971 individuals age 65 years and older. PIM use was defined by the Beers criteria. Drug-related problems (DRPs) were defined using ICD-9 codes. Forty percent of the 17,971 individuals filled at least 1 PIM prescription, and 13% filled 2 or more PIM prescriptions. Overall DRP prevalence among those with at least 1 PIM prescription was 14.3% compared to 4.7% in the non-PIM group (p < .001). In conclusion, preventing PIM use may be important for decreasing medication-related problems, which are increasingly being recognized as requiring an integrated interdisciplinary approach. Keywordsmedications; healthcare costs; geriatrics; adverse drug events Drug-related problems (DRPs) are prevalent in the older adult population and pose a major patient safety concern. DRPs arise because of the increasing number of medications required by this age group, fragmented systems of care, pre-existing health conditions, and the pharmacokinetic and pharmacodynamic changes that occur with aging (Bigos, Bies, & Pollock, 2006;Cusack, 2004;Gurwitz, 2004;Hajjar et al., 2003;Turnheim, 2004Turnheim, , 2005. Avoiding use of high-risk drugs is an important strategy in reducing DRPs. The purpose of this study was to examine both the prevalence of potentially inappropriate medication (PIMs) use among community-dwelling older adults and the association between PIMs and health care outcomes.One method promoted to identify high-risk medications is the use of an explicit list of PIMs. PIMs were first devised and publicized by Beers et al. for nursing home residents and subsequently expanded to include older adults in all settings (Beers, 1997). PIMs are medications identified through expert panel review as having risks that outweigh benefits (Beers et al., 1991). Since the early 1990s, the prevalence of PIMs has been examined in a (Lau, Kasper, Potter, & Lyles, 2004), outpatient (Aparasu & Sitzman, 1999Curtis et al., 2004), acute care (Onder et al., 2005), and community settings (Zhan et al., 2001). For research purposes, use of explicit criteria is generally preferred over the use of implicit criteria applied by expert reviewers.The clinical validity of using a list of medications based on expert panel review and explicit criteria has been questioned as being overly simplistic and not including all the common drugs causing problems in older adults (Crownover & Unwin, 2005;Shorr, 2004). Moreover, despite the numerous reports of the prevalence of PIMs, only a few investigators (Fu, Liu, & Christensen, 2004;Thapa, Gideon, Cost, Milam, & Ray, 1998) have examined whether PIMs are associated with adverse clinical outcomes. Therefore, we investigated the outcomes associated with PIM use in a population of community-dwelling older adults.The Beers criteria have been revised recently; hence, the current prevalence of PIMs in...

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“…On average, an older person takes four or five prescription drugs and two over-thecounter drugs each day. Also, older people are more than twice as susceptible to side effects of drugs as younger people [4] . As people age, the amount of water in the body decreases and the amount of fat tissue relative to water, increases.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Lack of Essential Information in Medical Literature

Alomar¹,

Hourani²,

Sulaiman³

et al. 2008

American J. of Pharmacology and Toxicology

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Primary literature is a basic tool for medical knowledge and for future research. Every researcher relies at some point on the information available in published literature. Also, primary literature is utilized to develop guidelines for the medical use of medications in all kinds of diseases, accuracy is a must in this regard. To evaluate essential information regarding patients, drugs and diseases omitted from efficacy literature on antihypertensive drug safety. Data on antihypertensive adverse drug reactions we retrospectively collected from 219 medical articles using search engines IDIS Iowa Drug Information Services, ScienceDirect, Medscape, Pubmed, Ebscohost, Inside web, Proquest, Emerald and Medline. The data for the study was collected from primary literature carried out on antihypertensive medications in previous years. All of the available information regarding patients (patient's factors) and drugs was collected in order to evaluate the percentage of the omitted data. 219 primary journal articles were collected, 640 medications from these articles were analyzed. Some of the 640 medications are the same but in different articles. Out of 640 medications collected, 15718 data entries were used which represent patient's factors and drug factors, age, gender, type of job, renal conditions, alcohol consumption, use of other medications, other diseases, drug dose, drug frequency, dosage form. All these factors were evaluated for the effect on developing adverse drug reactions. The omitted data was classified into four different categories. Age, gender, race, smoking, health status, medication use and any other information related to the patients is basic information which needs to be available in all literature, not just to be mentioned in the methodology and sampling, but to be specified carefully and fully in the results.

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Adverse drug reaction risk factors in older outpatients

Cited by 150 publications

References 25 publications

Effects of Polypharmacy on Adverse Drug Reactions among Geriatric outpatients at a Tertiary Care Hospital in Karachi, A prospective cohort study.

Effects of Polypharmacy on Adverse Drug Reactions among Geriatric outpatients at a Tertiary Care Hospital in Karachi, A prospective cohort study.

Health outcomes associated with potentially inappropriate medication use in older adults

Evaluation of the Lack of Essential Information in Medical Literature

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