Hospital admissions to geriatric ward related to adverse drug events: a cross-sectional study from the Czech Republic

Maříková, Martina; Nerad, Vladimír; Kubêna, Aleŝ; Bláha, V.; Vlček, Jiřı́

doi:10.1007/s11096-021-01237-y

Cited by 4 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent studies have also observed higher preventability: 60.9% ( Li et al, 2021 ) 42.9% ( Dechanont et al, 2021 ), 53.5% ( Maříková et al, 2021 ), 46% ( Kalisch Ellett et al, 2021 ) 47% ( Lombardi et al, 2020 ), 76.4% ( Cabre et al, 2018 ) 69% ( Giardina et al, 2018 ). However, most of them were limited to older patients, in whom the preventability is higher than in the general population.…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

Drug-Related Hospital Admissions via the Department of Emergency Medicine: A Cross-Sectional Study From the Czech Republic

2022

Self Cite

View full text Add to dashboard Cite

Background: Drug-related hospital admissions (DRAs) represent a significant problem affecting all countries worldwide. This study aimed to determine the prevalence and preventability of DRAs, identify the most common medications involved in DRAs, the most common clinical manifestations of DRAs and describe the preventability aspects of DRAs.Methods: This cross-sectional study examined unplanned hospital admissions to the University Hospital Hradec Králové via the department of emergency medicine in August–November 2018. Data were obtained from electronic medical records. The methodology of DRA identification was adapted from the OPERAM DRA adjudication guide.Results: Out of 1252 hospital admissions, 195 DRAs have been identified (145 related to treatment safety, 50 related to treatment effectiveness). The prevalence of DRAs was 15.6% (95% CI 13.6–17.6). The most common medication classes involved in DRAs related to treatment safety were Antithrombotic agents, Antineoplastic agents, Diuretics, Corticosteroids for systemic use, and Beta blocking agents. The most common medication classes involved in DRAs related to treatment effectiveness included Diuretics, Antithrombotic agents, Drugs used in diabetes, Agents acting on the renin-angiotensin system, and Lipid modifying agents. Gastrointestinal disorders were the leading causes of DRAs related to treatment safety, while Cardiac disorders were the leading causes of DRAs related to treatment effectiveness. The potential preventability of DRAs was 51%. The highest share of potential preventability in medication classes repeatedly involved in DRAs related to treatment safety was observed for Anti-inflammatory and antirheumatic products, Psycholeptics, and Drugs used in diabetes. Potentially preventable DRAs related to treatment safety were most commonly associated with inappropriate drug selection, inappropriate monitoring, inappropriate dose selection, and inappropriate lifestyle measures. On the contrary, DRAs related to treatment effectiveness were more commonly associated with medication nonadherence.Conclusion: It should be emphasized that in most DRAs, medications were only a contributory reason of hospital admissions and that benefits and risks have to be carefully balanced. It is highlighted by the finding that the same medication classes (Antithrombotic agents and Diuretics) were among the most common medication classes involved in DRAs related to treatment safety and simultaneously in DRAs related to treatment effectiveness. The study highlighted that apart from problems related to prescribing, problems related to monitoring and patient-related problems represent significant preventability aspects.

show abstract

Section: Discussionmentioning

confidence: 93%

“…This is the first study from the Czech Republic that examines DRAs without any department or age limit. In previous studies from the Czech Republic, the population studied was either from the pediatric ward ( Langerová et al, 2014 ) or the geriatric ward ( Maříková et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Drug-Related Hospital Admissions via the Department of Emergency Medicine: A Cross-Sectional Study From the Czech Republic

2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Considering that bleeding represents the most common clinical manifestation of DDI-related hospital admissions, additional DDIs related to increased risk of bleeding should be considered during the development of an updated list of potentially clinically significant DDI in older adults. Gastrointestinal hemorrhage represented the most common ADE also in our previous study focused on older patients admitted to the geriatric ward (Maříková et al, 2021). A combination of two antiplatelet agents was frequently implicated in serious ADRs associated with DDIs identified via a spontaneous reporting database from Italy (Magro et al, 2020).…”

Section: Figurementioning

confidence: 90%

Potentially clinically significant drug-drug interactions in older patients admitted to the hospital: A cross-sectional study

Maříková

Vlček

2023

Front. Pharmacol.

Self Cite

View full text Add to dashboard Cite

Background: An international consensus list of potentially clinically significant drug-drug interactions (DDIs) in older people has been recently validated. Our objective was to describe the prevalence and characteristics of drug combinations potentially causing clinically significant DDIs identified in the medication history of older patients admitted to the hospital and the prevalence and characteristics of manifest DDIs–DDIs involved in adverse drug events present at hospital admission, DDIs that contributed to ADE-related hospital admissions, and DDIs involved in drug-related laboratory deviations.Methods: The data were obtained from our previous study that examined the drug-relatedness of hospital admissions to University Hospital Hradec Králové via the department of emergency medicine in the Czech Republic. Patients ≥ 65 years old were included. Drug combinations potentially causing clinically significant DDIs were identified using the international consensus list of potentially clinically significant DDIs in older people.Results: Of the 812 older patients admitted to the hospital, 46% were exposed to drug combinations potentially causing clinically significant DDIs. A combination of medications that affect potassium concentrations accounted for 47% of all drug combinations potentially causing clinically significant DDIs. In 27 cases, potentially clinically significant DDIs were associated with drug-related hospital admissions. In 4 cases, potentially clinically significant DDIs were associated with ADEs that were present at admissions. In 4 cases, the potentially clinically significant DDIs were associated with laboratory deviations. Manifest DDIs that contributed to drug-related hospital admissions most frequently involved antithrombotic agents and central nervous system depressants.Conclusion: The results confirm the findings from the European OPERAM trial, which found that drug combinations potentially causing clinically significant DDIs are very common in older patients. Manifest DDIs were present in 4.3% of older patients admitted to the hospital. In 3.3%, manifest DDIs contributed to drug-related hospital admissions. The difference in the rates of potential and manifest DDIs suggests that if a computerized decision support system is used for alerting potentially clinically significant DDIs in older patients, it needs to be contextualized (e.g., take concomitant medications, doses of medications, laboratory values, and patients’ comorbidities into account).

show abstract

Medikamentenkomplikationen – Dosisfindung und Interaktionen

Keller

Schulte-Kemna

2023

Geriatrische Nephrologie

View full text Add to dashboard Cite

Hospital admissions to geriatric ward related to adverse drug events: a cross-sectional study from the Czech Republic

Cited by 4 publications

References 28 publications

Drug-Related Hospital Admissions via the Department of Emergency Medicine: A Cross-Sectional Study From the Czech Republic

Drug-Related Hospital Admissions via the Department of Emergency Medicine: A Cross-Sectional Study From the Czech Republic

Potentially clinically significant drug-drug interactions in older patients admitted to the hospital: A cross-sectional study

Medikamentenkomplikationen – Dosisfindung und Interaktionen

Contact Info

Product

Resources

About