A retrospective study on the incidences of adverse drug events and analysis of the contributing trigger factors

Sam, Aaseer Thamby; Jessica, Looi Li Lian; Parasuraman, Subramani

doi:10.4103/0976-0105.152095

Cited by 15 publications

(22 citation statements)

References 9 publications

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“…The same result was also obtained from a retrospective study that was conducted in Malaysia, in which most of the detected nonadherences were among elderly patients. The reasons behind it was low adherence, complicated medications, inability to understand medication instructions and high treatment costs which subsequently result in treatment failure, adverse reactions and increase rehospitalizations (Sam et al 2015). It can be said that most of the pharmacists agreed that the unawareness of the caretaker may result in medication errors at home.…”

Section: Discussionmentioning

confidence: 99%

The Willingness of Community Pharmacists in Collaborative Care of Frail Elderly in Nursing Homes

Al¹,

Omar²

2019

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An increase in the number of residents in nursing homes has become a significant concern due to the rise in medication demand and subsequently medicationrelated issues, especially in frail elderly. Community pharmacists are the closest healthcare professionals available that can contribute to this population to allow optimal utilization of the prescribed drugs and to prevent drug-related problems. The present study aimed to investigate the awareness of community pharmacists on issues regarding frail elderly and to determine their willingness in collaborative care of frail elderly in nursing homes and the services they are willing to offer. This was a cross-sectional study utilising a set of questionnaire that was delivered to practicing community pharmacists in Peninsular Malaysia from June 2018 until December 2018. Majority of the participants agreed to the fact that aging is the primary cause of frailty (n=98, 88.3%), and that chronic disease is also a cause of frailty (n=96, 86.5%). Most of the community pharmacists were also keen to participate in the collaborative care of frail elderly, and were willing to provide their pharmacy service to the frail elderly. There was a positive correlation between the awareness of community pharmacists on issues regarding frail elderly and their willingness on collaborative care of frail elderly in nursing homes (r=0.374, n=111, p=0.01). Majority of the pharmacists were aware of the issues regarding the frail elderly, and were willing to participate in the collaborative care of frail elderly in nursing home.

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Section: Discussionmentioning

confidence: 99%

The Willingness of Community Pharmacists in Collaborative Care of Frail Elderly in Nursing Homes

Al¹,

Omar²

2019

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“…Observational studies from USA, Canada, Australia and Italy also report high levels of polypharmacy [20,22]. Such high levels of polypharmacy raise concerns about the safety of un-trialed combinations of treatments for individual patients [23,24]. National regulations aim to ensure that the pharmaceuticals prescribed medications have been tested and found to be safe and effective, but this process relies upon RCT methodologies, with a single drug as the intervention in one condition at a time.…”

Section: Rcts and Their Relevance To Clinical Practicementioning

confidence: 99%

Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard?

2020

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Complementary medicines and therapies are popular forms of healthcare with a long history of traditional use. Yet, despite increasing consumer demand, there is an ongoing exclusion of complementary medicines from mainstream healthcare systems. A lack of evidence is often cited as justification. Until recently, high-quality evidence of treatment efficacy was defined as findings from well-conducted systematic reviews and meta-analyses of randomized controlled trials. In a recent and welcome move by the Oxford Centre for Evidence-Based Practice, however, the N-of-1 trial design has also been elevated to the highest level of evidence for treatment efficacy of an individual, placing this research design on par with the meta-analysis. N-of-1 trial designs are experimental research methods that can be implemented in clinical practice. They incorporate much of the rigor of group clinical trials, but are designed for individual patients. Individualizing treatment interventions and outcomes in research designs is consistent with the movement towards patient-centered care and aligns well with the principles of holism as practiced by naturopaths and many other complementary medicine practitioners. This paper explores whether rigorously designed and conducted N-of-1 trials could become a new ‘gold standard’ for demonstrating treatment efficacy for complementary medicine interventions in individual patients in clinical practice.

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“…utilized in busy clinical settings and has been widely reported in literature to objectively determine the severity of ADRs in older adults [18].…”

Section: Study Design and Eligibility Criteriamentioning

confidence: 99%

Untitled

2019

J Geriatr Med Gerontol

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Background: The complex interplay between altered pharmacokinetics and pharmacodynamics, greater multimorbidity and polypharmacy, are associated with increased risk of adverse drug reactions (ADR) in older adults. There remains a paucity of data on the association between frailty and ADRs. We aimed to determine the association between frailty and the prevalence, presentation and severity of ADRs among hospitalized older adults. Methods: This was a retrospective, cross-sectional study in an acute care hospital in Singapore. The first 150 older adults admitted from emergency department or outpatient clinic under Geriatric Medicine service in September 2016 were included. We used Clinical Frailty Scale (CFS) to determine frailty status. Probability and severity of ADRs were determined using Naranjo and Hartwig Scale respectively. Results: The prevalence of frailty was 83.3%; mean age and CFS were 89.7 ± 4.0 years, and 6 ± 1.3 respectively. Majority (70%) experienced at least 1 side effect; more than 40% of these ADRs were of mild to moderate in severity. Constipation was the most common ADR (41.3%) and was associated with calcium supplement. ACE-inhibitors, diuretics and anti-platelets were also frequently associated with ADRs in older adults. Frail older adults significantly experienced lesser cardiovascular ADRs but more central nervous system ADRs compared to the non-frail group (P < 0.05). Conclusions: There is a high prevalence of frailty and ADRs in hospitalized older adults, with ADRs mostly mild to moderate in severity. More robust studies to prospectively explore the relationship between frailty and ADRs are required.

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A retrospective study on the incidences of adverse drug events and analysis of the contributing trigger factors

Cited by 15 publications

References 9 publications

The Willingness of Community Pharmacists in Collaborative Care of Frail Elderly in Nursing Homes

The Willingness of Community Pharmacists in Collaborative Care of Frail Elderly in Nursing Homes

Practice-Based Research in Complementary Medicine: Could N-of-1 Trials Become the New Gold Standard?

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