Age- and gender-related differences in drug utilisation and adverse drug reaction patterns among patients in a coronary care unit

Abstract

INTRODUCTIONThis study aimed to examine age-and gender-related differences in the comorbidities, drug utilisation and adverse drug reaction (ADR) patterns of patients admitted to a coronary care unit (CCU). MeThODsThe present study was a retrospective cohort study. Two trained physicians independently reviewed the case records of CCU patients over a period of one year (Jan-Dec 2008). The demographic, clinical, and drug prescription data of the patients were analysed according to age group (18-59 years vs ≥ 60 years) and gender.ResUlTs A total of 574 patients were admitted to the CCU during the study period. Of these 574 patients, 65.2%were male, and 48.4% were ≥ 60 years old. No significant gender-based differences were found for the prescription of cardiovascular and non-cardiovascular drugs, and ADR patterns (p > 0.05). Male patients aged ≥ 60 years were found to have a higher rate of polypharmacy than those aged 18-59 years (p = 0.001). The duration of hospital stay was longer in male than female patients (p = 0.008), and the duration of CCU stay was longer for male patients aged ≥ 60 years than males aged 18-59 years (p = 0.013). Compared to patients aged 18-59 years, a greater number of patients aged ≥ 60 years were prescribed cardiovascular (p = 0.006) and non-cardiovascular drugs (p = 0.015). Patients aged ≥ 60 years also had a higher rate of polypharmacy (p = 0.001) and ADRs (p = 0.013), and a longer duration of CCU stay (p = 0.013). Renal (p = 0.047) and cutaneous (p = 0.003) ADRs were found to be more common in patients aged ≥ 60 years. CONClUsIONNo major gender-related differences were observed in the prescription, drug utilisation and ADR patterns of our study cohort. Higher drug utilisation, ADR rates, and longer duration of CCU stay were noted in patients aged ≥ 60 years.

Pharmacovigilance Research in India: A Five-Year Literature Review

“…Another retrospective study identified no significant gender-based differences in ADR patterns (p>0.05) in coronary care unit patients. But, this study found that the patients aged >60 years had a higher rate of ADRs (p=0.013) than patients aged 18-59 years (Kunnoor et al, 2014).…”

Adverse drug reaction profile in Amravati region of India: A pharmacovigilance study

“…found that ADRs are more common among females but they opined that further work is needed to elucidate the reason behind such differences. [ 20 ] Kunnoor et al [ 23 ] in their study, which was conducted on patients admitted to a coronary care unit found gender-related differences in the ADR patterns, although polypharmacy was more common in males but ADRs were 1.5- to 1.7-fold more common in females than males. Their explanation for these differences was different pharmacokinetic, pharmacodynamic, immunological, and hormonal factors in females as well as differences in the pattern of use of medications in them.…”

Clinical Pharmacology in India-A Systematic Review of Research in the Past 5 Years

“…The maximum number of studies were found in this category, even a systematic review has been done (Bachhav and Kshirsagar, 2015). These studies were hospital- (Mittal et al, 2014) or ward-or unit-oriented, for instance medical emergency (Dhamija et al, 2013;, CCU (Kunnoor et al, 2014), disease (eclampsia)-oriented (Kumar et al, 2014); although we found an interesting study that focused on one drug, pioglitazone . The late Prof. RR Chaudhary had asked us to conduct a drug utilization study to provide background data so that appropriate amendments regarding drug procurement and dispensing policies can be made (Singh et al, 2010) although we did not find recent studies conducted for this purpose.…”