An Intensive Monitoring of Adverse Drug Reactions among Elderly Patients Hospitalized in Medical Wards of a Tertiary Care Hospital

Abstract

Objective: To evaluate the pattern of adverse drug reactions in elderly patients hospitalized in medical wards at a tertiary care hospital in India. Methods: Elderly patients ≥ 60 years hospitalized in three randomly selected medical units were enrolled and followed up daily till discharge. Detailed information of patients and ADRs were recorded by interviewing patients, doctors and nurses. Appropriateness of drug treatment in patients≥65 years was analyzed using Beer's criteria. ADRs were assessed for incidence, onset, duration, management, outcome, causality, severity, preventability, seriousness and risk factors. Results: A total of 1017 patients were enrolled (mean age: 69.5±7.6 years); majority (80.9%) suffered from >1 ailments. Patients received 6.3±0.5 drugs, commonly by oral (48%) and intravenous (41.6%) routes. Inappropriate drug therapy was observed in 76 patients of ≥65 years. ADRs were observed in 107(10.7%) patients, majority occurred within first week, commonly affected GI (29.9%), central and peripheral nervous system (17.8%) and were frequently associated with antimicrobials (44.2%), drugs acting on CVS (13.3%) and endocrine systems (12.5%). Majority of reactions were mild (55.1%), non-serious (73.8%), not preventable (85.9%), recovered completely at discharge (87.8%) and had possible causal association with suspect drug (68.2%). Age>80 years, ≥3 diseases, prescription of >10 drugs and hospitalization for>4 days were risk factors for occurrence of ADRs. Conclusion:Adverse reactios are common in elderly and were frequently affect gastrointestinal, central and peripheral nervous systems. Reactions are mild, non-serious and commonly caused by antimicrobials and drugs acting on cardiovascular or endocrine systems. Multiple diseases, polytherapy, age>80 years and hospitalization>4 days increase the risk of ADRs.

Pattern of adverse drug reaction in geriatric inpatients of medicine in a tertiary care center: a prospective observational study

“…In our findings maximum ADR were possible 63 (75%) next is probable 19 (22.6%) but only 02 (3.57%) were certain those are comparable with another study Kamejaliya et al possible 68.2% next is probable 31.7%. 22 Those results were similar to our findings. We have, however, experienced that the WHO-UMC method is simple and less time consuming.…”

“…Comparison between different study like Kamejaliya et al and Mandavi et al in-Preventability Assessment scale is similar to my study. 18,22 This helps to prevent the undesirable drug effects and undertake the right steps in right direction. In our study, however had a few short-coming also.…”

Assessment of Adverse Drug Reactions on Cardiovascular Drugs in Hospitalized Patients of a Tertiary Care Hospital – A Prospective Analysis

“…It was found that the maximum number of ADRs was possible (40%) followed by probable which was (34%). This is because of difference in the health-care system and varies from place to place [15].…”

Pattern of Adverse Drug Reactions Reported with Use of Antimicrobial Drugs in a Tertiary Care Hospital

“…This is less as compared to previous studies which involved intensive monitoring. 19 Categorization according to CTCAE showed skin to be most commonly affected organ system with maculopapular rash being observed in 22.37% of patients followed by pruritis and urticaria. Our findings are supported by various studies.…”