Adverse Drug Reactions in Older Adults: a Retrospective Study from Pharmacovigilance

Charfi, Rim; Aidli, Sihem El; Zaiem, Ahmed; Kastalli, Sarrah; Srairi, S.; Daghfous, Riadh; Lakhal, Mohamed

doi:10.2515/therapie/2012059

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…The most frequently reported ADRs according to MedDRA SOC were general disorders and administration site conditions, skin and subcutaneous tissue reactions and gastrointestinal disorders, as shown in other studies [25,52]. These types of ADR are also frequent in the ADR group including PIM.…”

Section: Discussionsupporting

confidence: 52%

Adverse Drug Reactions and Potentially Inappropriate Medication in Older Patients: Analysis of the Portuguese Pharmacovigilance Database

Gomes

Herdeiro

Ribeiro-Vaz

et al. 2022

JCM

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Criteria have been developed to identify potentially inappropriate medications that can enhance adverse reactions, highly prevalent in older patient’s therapy. This study aimed to identify potentially inappropriate medications within the adverse drug reactions reported in the Portuguese pharmacovigilance system, characterizing the reports where inappropriate medications were identified. INFARMED, I.P. provided all adverse drug reactions reported from January to December 2019 in 65-year-old and older patients. Adverse drug reactions were characterized according to the System Organs Classes, seriousness, and medications with the Anatomical Therapeutical Classification. Potentially inappropriate medications were identified by applying the EU-(7)-PIM and the Beers criteria. A p value < 0.05 was considered statistically significant. From the 2337 reports considered for the analysis, PIMs were found in 12.8% of these, and 64.7% of all adverse reaction reports were classified as serious. Within the group of reports including at least one PIM, 71.4% were classified as serious, with hospitalization the most common criteria (35.1%). From the 3170 suspected medicines identified, 10.6% were classified as PIMs. Amiodarone was the most frequent PIM identified in the study (10.1%). Reports including at least one PIM were more associated with a higher number of ADRs (p = 0.025) reported in the same record, higher number of suspected medicines identified (p < 0.001), seriousness (p = 0.005), and hospitalization (p < 0.001). Potentially inappropriate medications are important enhancers of serious adverse drug reactions, increasing the likelihood of hospitalizations. This reinforces the importance of improving medication appropriateness in the older population.

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Section: Discussionsupporting

confidence: 52%

Adverse Drug Reactions and Potentially Inappropriate Medication in Older Patients: Analysis of the Portuguese Pharmacovigilance Database

Gomes

Herdeiro

Ribeiro-Vaz

et al. 2022

JCM

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“…For example, a Dutch study of 84 patients with postherpetic neuralgia (PHN – a well-known complication of shingles) reported that 89% of patients took prescription medications such as antidepressants, opioids, various analgesics as well as antiepileptic medicines ( 32 ). The elderly are highly susceptible to side-effects from medications, partly because they generally take more than one medication, and there is often no dose adjustment ( 33 ). Polypharmacy is known to be associated with negative health outcomes and a major cause of drug interactions and safety problems in this age group ( 34 ).…”

Section: Reduction In Treatment Prescriptionmentioning

confidence: 99%

Role of vaccination in the sustainability of healthcare systems

Largeron

Lévy

Wasem

et al. 2015

Journal of Market Access & Health Policy

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The use of vaccines to prevent diseases in children, adults, and the elderly results in fewer medical visits, diagnostic tests, treatments, and hospitalisations, which leads to substantial savings in healthcare costs each year in Europe and elsewhere. Vaccines also contribute to reducing resource utilisation by preventing nosocomial infections, such as rotavirus gastroenteritis, which can increase hospital stays by 4–12 days. Vaccination also has an important role in the prevention of cancers with, for example, human papillomavirus or hepatitis B vaccines. Since the financial impact of cancer is high for patients, healthcare systems, and society as a whole, any cases prevented will reduce this impact. Newer vaccines, such as the herpes zoster vaccine, can provide an answer to unmet medical needs by preventing and reducing the severity of shingles and associated post-herpetic neuralgia, which are difficult conditions to treat. Thus, in the context of increasing pressure on healthcare budgets, vaccination can contribute to the sustainability of healthcare systems through reduced and more efficient use of healthcare resources.

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“…Dies lässt sich auch daraus ablesen, dass sich das NebenwirkungRisiko ab fünf Medikamenten verdoppelt und ab sieben bis acht Medikamenten verdreifacht. Häufig haben ältere Patienten mit Polymedikation auch eine eingeschränkte renale oder hepatische Funktion und so eine veränderte Pharmakokinetik und Pharmakodynamik der eingesetzten Medikamente, was die Gefahr möglicher Interaktionen weiter erhöht [27]. Die häufigsten medikamentös-erworbenen Gerinnungsstörungen sind zweifellos Thrombozytenfunktionsstörungen [28].…”

Section: Rivaroxabanunclassified

Direkte orale Antikoagulantien und Medikamenteninteraktionen

Graf

Korte

2015

Therapeutische Umschau

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Die Vitamin K Antagonisten (beispielsweise Marcoumar) gehören zu den Medikamenten mit den häufigsten Medikamenten- und Nahrungsmittelinteraktionen. Die neueren direkten oralen Antikoagulantien (DOACs) haben diesbezüglich einen potentiellen Vorteil. Bedingt durch ihren Metabolismus zeigen allerdings auch diese neueren Substanzen Interaktionen mit bestimmten Medikamenten. Diese Interaktionen führen zu höheren oder tieferen Plasmaspiegeln und konsekutiv zu einem erhöhten Blutungsrisiko oder einer verminderten Wirksamkeit. Kaum erforscht ist bislang das Interaktionsrisiko von Polymedikationen mit den DOACS. Bei den Vitamin K Antagonisten ist bekannt, dass Patienten mit gleichzeitiger Polymedikation ein deutlich erhöhtes Blutungsrisiko aufweisen. Polymedikation ist häufiger bei älteren Patienten zu finden. Dies ist jedoch auch gerade die Population, die häufiger eine Indikation für eine Antikoagulation hat. Bekannterweise führt eine ganze Reihe von Medikamenten zu Thrombozytenfunktionsstörungen. Es ist sehr wahrscheinlich, dass das Blutungsrisiko bei Einnahme eines DOAC und gleichzeitig bestehender Thrombozytenfunktionsstörung deutlich ansteigt. Dementsprechend ist es unabdingbar, dass bei Verschreibung eines DOACS nicht nur dessen Nebenwirkungspotential, sondern auch jenes der bereits eingenommenen Substanzen berücksichtigt wird und gleichzeitig die Notwendigkeit der Medikation kritisch überprüft wird.

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Adverse Drug Reactions in Older Adults: a Retrospective Study from Pharmacovigilance

Cited by 8 publications

References 12 publications

Adverse Drug Reactions and Potentially Inappropriate Medication in Older Patients: Analysis of the Portuguese Pharmacovigilance Database

Adverse Drug Reactions and Potentially Inappropriate Medication in Older Patients: Analysis of the Portuguese Pharmacovigilance Database

Role of vaccination in the sustainability of healthcare systems

Direkte orale Antikoagulantien und Medikamenteninteraktionen

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