Adverse Drug Reactions as Cause of Hospital Admissions: Results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA)

Onder, Graziano; Pedone, Claudio; Landi, Francesco; Cesari, Matteo; Vedova, Cecilia Della; Bernabei, Roberto; Gambassi, Giovanni

doi:10.1046/j.1532-5415.2002.50607.x

Cited by 421 publications

(323 citation statements)

References 51 publications

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“…We stress that both STOPP and Beers' criteria are designed to identify prescription medicines that are potentially inappropriate for older patients. Nevertheless, prescribing of inappropriate drugs is associated with a significant increase in adverse drug events (ADEs) and iatrogenic morbidity [28,29]. Although STOPP and Beers' criteria contain comparable numbers of potential IP avoidance rules, in this study 43% of the STOPP potential IP rules were breached compared with 28% of Beers' criteria rules.…”

Section: Discussionmentioning

confidence: 76%

Potentially inappropriate prescribing in an Irish elderly population in primary care

Ryan¹,

O’Mahony

Kennedy³

et al. 2009

Brit J Clinical Pharma

251

255

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Potentially inappropriate prescribing in older people is a well‐documented problem and has been associated with adverse drug reactions and hospitalization.• Beers' criteria, Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) are screening tools that have been formulated to help physicians and pharmacists identify potentially inappropriate prescribing and potential prescribing omissions.• The prevalence of potentially inappropriate prescribing and prescribing omissions in the elderly population presenting to hospital with acute illness is high according to STOPP and START criteria. WHAT THIS STUDY ADDS • Potential errors of prescribing and of omission of medicines are prevalent among medically stable older people in primary care.• Screening tools should be incorporated into the everyday practice of primary care doctors and community pharmacists as a means of preventing potential errors of prescribing commission and prescribing omission in older people.AIMS Screening tools have been formulated to identify potentially inappropriate prescribing (IP) in older people. Beers' criteria are the most widely used but have disadvantages when used in Europe. New IP screening tools called Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) have been developed to identify potential IP and potential prescribing omissions (PPOs). The aim was to measure the prevalence rates of potential IP and PPOs in primary care using Beers' criteria, STOPP and START.METHODS Case records of 1329 patients ≥65 years old from three general practices in one region of southern Ireland were studied. The mean age ± SD of the patients was 74.9 ± 6.4 years, 60.9% were female. Patients' current diagnoses and prescription medicines were reviewed and the Beers' criteria, STOPP and START tools applied.RESULTS The total number of medicines prescribed was 6684; median number of medicines per patient was five (range 1–19). Overall, Beers' criteria identified 286 potentially inappropriate prescriptions in 18.3% (243) of patients, whilst the corresponding IP rate identified by STOPP was 21.4% (284), in respect of 346 potentially inappropriate prescriptions. A total of 333 PPOs were identified in 22.7% (302) of patients using the START tool.CONCLUSION Potentially inappropriate drug prescribing and errors of drug omission are highly prevalent among older people living in the community. Prevention strategies should involve primary care doctors and community pharmacists.

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Section: Discussionmentioning

confidence: 76%

Potentially inappropriate prescribing in an Irish elderly population in primary care

Ryan¹,

O’Mahony

Kennedy³

et al. 2009

Brit J Clinical Pharma

251

255

View full text Add to dashboard Cite

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“…The results of this study indicate that for every new specialty that participates in the care process, the probability that a patient will suffer an ADE increases by 12-28%, even after adjusting for known ADE risk factors such as age, sex, polypharmacy, frequency of primary care physician visits, and the burden of morbidity itself. While some factors such as age, sex, and level of multimorbidity have a direct relationship with the disease severity and clinical situation of the patient, [13][14][15] the undesirable effects of other factors, such as polypharmacy, frequency of family physician visits, and referrals to specialists, can be minimised. This reduction can be accomplished through new models of e823 British Journal of General Practice, December 2012 professional practice, increased availability of adequate informative tools, or other improvement interventions.…”

Section: Discussionmentioning

confidence: 99%

Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?

Poblador‐Plou²,

et al. 2012

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This study aims to analyse the influence of these factors (multimorbidity, polypharmacy, and multiple referrals) on the frequency of ADEs, as an indicator of therapeutic safety, in the context of a national healthcare system. METHODThis was a multicentre observational study of patients treated at seven urban primary care centres in Zaragoza, Spain. Selection of centres to participate in this study was conducted based on the following quality inclusion criteria: (a) centres with computerised records for all appointments Research Abstract BackgroundThe consequences of multimorbidity include polypharmacy and repeated referrals for specialised care, which may increase the risk of adverse drug events (ADEs).

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“…14 Camargo AL. et al (2006) and Onder G. et al (2002) have shown that patients taking more medications suffer from ADRs. Likewise, the present study also revealed number of drugs as a significant risk factor for ADRs with each additional medication multiplying the risk of an ADR.…”

Section: Discussionmentioning

confidence: 99%

A prospective study on prevalence of adverse drug reactions due to antibiotics usage in otolaryngology department of a tertiary care hospital in North India

Khan

Nizamuddin

Huda

et al. 2013

Int J Basic Clin Pharmacol

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Background: Polypharmacy, advancing age and longer duration of hospital stay are the factors responsible for adverse drug reactions (ADRs). This study has attempted to analyze the pattern of antimicrobial prescription in OPD & IPD of the Otolaryngology department and to detect, document, assess and report the suspected ADRs due to antibiotic use and preparation of guidelines to minimize the incidence of ADRs. Methods: A prospective study conducted at the TMMC&RC on patients aged >40 years, who visited the Otolaryngology department over a period of 5 months. Suspected ADRs were assessed for causality and severity using Naranjo’s probability scale and modified Hartwig’s criteria, respectively. Results: Out of 1200, 925 prescriptions were analyzed. Most patients were from 41-60 age (59.45%) followed by 61-80 age (37.29%) and least from >80 yr (3.24%). But the incidence of ADRs were found to be higher in patients of >80 yr age group n=8 (26.66%). The most commonly prescribed antibacterials were β-Lactams (64.61%). Out of 925 prescriptions studied, only 94 were found to have 154 ADRs. The most commonly identified ADRs were Gastrointestinal 47.40%, followed by Neurotoxicity 24.67%, cutaneous reactions 20.12%, Hepatic 4.54% and Kidney 3.24%. 74.67% of the ADRs were probable and 20.77% were possible type and only 4.54% were definite. 74.67% ADRs were found to be type A, and 25.32% type B. Conclusions: Our study showed that prevalence of ADRs was highest in elder age group and diarrhea was the most common ADR found. Therefore elderly patients should be given special attention when prescribing medications to avoid clinically significant harmful consequences. Minimizing unnecessary antibiotic use by even a small percentage could signiﬁcantly reduce the immediate and direct risks of drug-related adverse events in individual patients. [Int J Basic Clin Pharmacol 2013; 2(5.000): 548-553

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Adverse Drug Reactions as Cause of Hospital Admissions: Results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA)

Abstract: The most important determinant of risk for ADR-related hospital admissions in older patients is number of drugs being taken. When considering only severe ADRs, risk is also related to age and frailty.

Cited by 421 publications

References 51 publications

Potentially inappropriate prescribing in an Irish elderly population in primary care

Potentially inappropriate prescribing in an Irish elderly population in primary care

Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?

A prospective study on prevalence of adverse drug reactions due to antibiotics usage in otolaryngology department of a tertiary care hospital in North India

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