Adverse Drug Events in Older Patients Admitted as an Emergency

Dormann, Harald; Sonst, Anja; Müller, Fabian; Vogler, Renate; Patapovas, Andrius; Pfistermeister, Barbara; Plank-Kiegele, Bettina; Kirchner, Melanie; Hartmann, Nina; Bürkle, Thomas; Maas, Renke

doi:10.3238/arztebl.2013.0213

Cited by 57 publications

(45 citation statements)

References 21 publications

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“…Although some studies show that drugs in the PIM criteria contributed to only a small percentage of ADRs, 43 a recent study with a different design demonstrated an association between PRISCUS drugs and ADRs. 10 More importantly, Koyama and colleagues found that patients taking PIMs and drugs with high anticholinergic effects are at higher risk of functional and cognitive impairment in a 5-year prospective cohort study. 44 Their study implied that the adverse events related to PIMs may be difficult to identify in cross-sectional studies.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies showed that PIMs were associated with adverse drug reactions (ADRs), ADR-associated medical errors (MEs) and negative clinical outcomes, 8 9 even though the PIMs were not directly responsible for these events. 10 Explicit criteria of PIMs are defined as a list of drugs which are considered inappropriate in general or for older adults with certain chronic conditions. In contrast, implicit criteria of PIMs are statements that are used to evaluate the appropriateness of individual drugs prescribed for older patients.…”

Section: Introductionmentioning

confidence: 99%

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Application of three different sets of explicit criteria for assessing inappropriate prescribing in older patients: a nationwide prevalence study of ambulatory care visits in Taiwan

Yang

Lai

et al. 2015

BMJ Open

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ObjectiveTo investigate the national prevalence of potentially inappropriate medications (PIMs) prescribed in ambulatory care clinics in Taiwan according to three different sets of regional criteria and the correlates of PIM use.DesignCross-sectional study.SettingThis analysis included older patients who visited ambulatory care clinics in 2009 and represented half of the older population included on the Taiwanese National Health Insurance Research Database.ParticipantsWe identified 1 164 701 subjects who visited ambulatory care clinics and were over 65 years old in 2009.Primary and secondary outcome measuresPIM prevalence according to the 2012 Beers criteria, the PIM-Taiwan criteria and the PRISCUS criteria was estimated separately, and characteristics of PIM users were explored. Multivariate logistic regression analysis was used to determine patient factors associated with the use of at least one PIM. Leading PIMs for each set of criteria were also listed.ResultsThe prevalence of having at least one PIM at the patient level was highest with the Beers criteria (86.2%), followed by the PIM-Taiwan criteria (73.3%) and the PRISCUS criteria (66.9%). Polypharmacy and younger age were associated with PIM use for all three sets of criteria. The leading PIMs detected by the PIM-Taiwan and PRISCUS criteria were all included in the 2012 Beers criteria. Non-COX-selective non-steroidal anti-inflammatory drugs in the Beers criteria and benzodiazepines in the PIM-Taiwan and PRISCUS criteria accounted for most leading PIMs.ConclusionsThe prevalence of PIMs was high among older Taiwanese patients receiving ambulatory care visits. The prevalence of PIM and its associated factors varied according to three sets of criteria at the population level.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Application of three different sets of explicit criteria for assessing inappropriate prescribing in older patients: a nationwide prevalence study of ambulatory care visits in Taiwan

Yang

Lai

et al. 2015

BMJ Open

View full text Add to dashboard Cite

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“…DDI represents one of the most frequent adverse drug events that result in hospitalization, increase of cardiovascular risk, and abandonment of treatment. These induce adverse events or reduce the therapeutic efficacy, particularly in individuals subjected to polypharmacy 5 .…”

Section: Introductionmentioning

confidence: 99%

Potential drug interactions in patients given antiretroviral therapy

Santos

Secoli

Padoin

2016

Rev. Latino-Am. Enfermagem

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Objective:to investigate potential drug-drug interactions (PDDI) in patients with HIV infection on antiretroviral therapy. Methods:a cross-sectional study was conducted on 161 adults with HIV infection. Clinical, socio demographic, and antiretroviral treatment data were collected. To analyze the potential drug interactions, we used the software Micromedex(r). Statistical analysis was performed by binary logistic regression, with a p-value of ≤0.05 considered statistically significant. Results:of the participants, 52.2% were exposed to potential drug-drug interactions. In total, there were 218 potential drug-drug interactions, of which 79.8% occurred between drugs used for antiretroviral therapy. There was an association between the use of five or more medications and potential drug-drug interactions (p = 0.000) and between the time period of antiretroviral therapy being over six years and potential drug-drug interactions (p < 0.00). The clinical impact was prevalent sedation and cardiotoxicity. Conclusions:the PDDI identified in this study of moderate and higher severity are events that not only affect the therapeutic response leading to toxicity in the central nervous and cardiovascular systems, but also can interfere in tests used for detection of HIV resistance to antiretroviral drugs.

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“… 30 35 36 53 These issues are important since the current situation regarding patient safety is alarming with adverse drug reactions and/or medication errors being the reason for admission to the emergency department for one out of five patients. 63 …”

Section: Discussionmentioning

confidence: 99%

Benefits of medication charts provided at transitions of care: a narrative systematic review

2020

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ObjectivesParticularly at transitions of care points information concerning current medication tends to be incomplete. A medication chart that contains all essential information on current therapy is likely to be a helpful tool for patients and healthcare providers. We aimed to investigate any type of benefits associated with medication charts provided at transition points.MethodsA systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. Two databases, two online journals and two association websites dedicated to biomedicine and pharmacy issues were consulted to identify studies for the review using the search term ‘medication chart’ and synonyms. We run our search from database inception up to March 2019. Studies of any study design, intervention and population which examined the effect of paper-based medication charts were included. We extracted study results narratively and coded and classified them by themes and categories inductively by using the ‘framework method’ with content analysis. The methodological quality of the studies was assessed using the Effective Public Health Practice Project (EPHPP) tool.ResultsFrom the 846 retrieved articles, 30 studies met the inclusion criteria, mostly from Germany (18 studies) and the USA (5 studies). Thirteen studies reported a statistically significant result. In the ‘patient theme’, the most obvious benefits were an increase in medication knowledge, a reduction of medication errors and higher medication adherence. In the ‘interdisciplinary theme’, a medication chart represented a helpful tool to increase communication and inter-sectoral cooperation between healthcare providers. In the ‘theme of terms and conditions’, accuracy and currency of data are prerequisites for any positive effect. The quality of the studies was classified predominantly weak mainly due to unmet good quality criteria (no randomised controlled trials study design, no reported dropouts).ConclusionOverall, the reviewed studies suggested some benefits when using medication charts. Healthcare providers could consider using medication charts in their counselling practice. However, it is unknown whether the reported benefits lead to measurable improvement in clinical outcomes.PROSPERO registration number

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Adverse Drug Events in Older Patients Admitted as an Emergency

Abstract: Elderly patients more frequently suffer from ADR and from the clinical consequences of medication errors. Elderly patients taking PIMs are more likely to suffer from ADRs and MEs, even though most drug-related events are still attributable to non-PIM.

Cited by 57 publications

References 21 publications

Application of three different sets of explicit criteria for assessing inappropriate prescribing in older patients: a nationwide prevalence study of ambulatory care visits in Taiwan

Application of three different sets of explicit criteria for assessing inappropriate prescribing in older patients: a nationwide prevalence study of ambulatory care visits in Taiwan

Potential drug interactions in patients given antiretroviral therapy

Benefits of medication charts provided at transitions of care: a narrative systematic review

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