Association of Adverse Drug Events with Hospitalization Outcomes and Costs in Older Adults in the USA using the Nationwide Readmissions Database

Riaz, Munaza; Brown, Joshua D.

doi:10.1007/s40290-019-00286-z

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…In older adults, ADEs disproportionately contribute to severe health outcomes. ADEs are associated with between 3% and 30% of all hospital admissions and ADEs increase the risk of emergency department visits, increased in-hospital morbidity and mortality, and increased health care expenditure [38,[41][42][43][44][45][46][47][48][49][50]. It is estimated that up to 50% of all ADEs are avoidable, preventable, or ameliorable in that they can either be prevented through selecting alternative therapies to avoid drug-drug interactions or can be reduced through dose reductions or preventive measures against side effects [44,[51][52][53].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Older Adults Who Were Early Adopters of Medical Cannabis in the Florida Medical Marijuana Use Registry

Brown

Costales

Boemmel-Wegmann

et al. 2020

JCM

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Use of medical marijuana is increasing in the United States and older adults are the fastest growing user group. There is little information about the characteristics and outcomes related to medical marijuana use. This study is a descriptive analysis of older adults (aged ≥50 years old) who were early adopters of a medical marijuana program in the U.S. state of Florida. Per state legislation, initial and follow-up treatment plans were submitted to the University of Florida College of Pharmacy. Data collection included demographics, clinical history, medical conditions, substance use history, prescription history, and health status. Follow-up treatment plans noted changes in the chief complaint and actions taken since the initial visit. Of the state’s 7548 registered users between August 2016 and July 2017, N = 4447 (58.9%) were older adults. Patients utilized cannabidiol (CBD)-only preparations (45%), preparations that had both tetrahydrocannabinol (THC) and CBD (33.3%) or were recorded to use both CBD-only and THC + CBD products (21.7%). The chief complaints indicating medical cannabis treatment were musculoskeletal disorders and spasms (48.4%) and chronic pain (45.4%). Among other prescription medications, patients utilized antidepressants (23.8%), anxiolytics and benzodiazepines (23.5%), opioids (28.6%), and cardiovascular agents (27.9%). Among all drug classes with potential sedating effects, 44.8% of the cohort were exposed to at least one. Patients with follow-up visits (27.5%) exhibited marked improvement as assessed by the authorizing physicians. However, the patient registry lacked detailed records and linkable information to other data resources to achieve complete follow up in order to assess safety or efficacy. Future improvements to registries are needed to more adequately capture patient information to fill knowledge gaps related to the safety and effectiveness of medical marijuana, particularly in the older adult population.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Older Adults Who Were Early Adopters of Medical Cannabis in the Florida Medical Marijuana Use Registry

Brown

Costales

Boemmel-Wegmann

et al. 2020

JCM

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“…Hospitalization with an ADE was associated with a 2.2-day increase in length of stay, at an additional cost of US$3782. 6 In the United Kingdom, it has been estimated that medication errors cause 12 000 deaths per year, contributing to an additional £0.75 billion to £1.5 billion in health care expenditures. 7 A systematic review, including studies conducted in primary care and hospital settings, found mean costs per medication error ranging from €2.58 to €111 727.08.…”

Section: Introductionmentioning

confidence: 99%

Patient Factors Associated with Pharmaceutical Interventions for Inpatients at a Brazilian Teaching Hospital

Francisco

Paz

Didone

2021

CJHP

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Background: Pharmaceutical interventions aim to correct or prevent a drug-related problem (DRP) that might lead to negative clinical consequences and increase health care costs. Objective: To identify variables associated with the provision of pharmaceutical interventions by clinical pharmacists during hospitalization. Methods: In this retrospective cohort study, adult inpatients of the medical ward of the University Hospital of the University of São Paulo in São Paulo, Brazil, were followed from admission to discharge. Logistic regression models were used to evaluate the association between occurrence of at least 1 pharmaceutical intervention and the following baseline characteristics: sex, age, Charlson comorbidity index, renal failure, electrolyte imbalance, hemoglobin, platelet count, and use of a nasoenteric tube, as well as the number, second-level Anatomical Therapeutic Chemical (ATC) code, and administration route of prescribed medications. Results: A total of 148 patients were included in the study, of whom 75 (50.7%) were men. The mean age was 62.8 (95% confidence interval [CI] 59.9–65.8) years, and the mean length of the hospital stay was 10.7 (95% CI 8.4–13.1) days. Analgesics (ATC code N02), the most common type of medication, were prescribed to 144 (97.3%) of the patients. Pharmaceutical interventions were performed for only 49 (33.1%) of the patients. One out of every 4 of these interventions was intended to obtain information not provided in the prescription, to allow the prescription to be completed and dispensing to proceed. According to the multivariate analysis, the odds ratio (OR) of occurrence of at least 1 pharmaceutical intervention increased for patients with electrolyte imbalance (OR 2.68, 95% CI 1.09–6.63; p = 0.033), patients using 5 to 8 medications (OR 8.73, 95% CI 1.07–71.36; p = 0.043), patients using 9 or more medications (OR 10.39, 95% CI 1.28–84.05; p = 0.028), and patients using at least 1 systemic antibacterial (ATC code J01; OR 2.76, 95% CI 1.30–5.84; p = 0.008). Conclusions: The findings of this study could allow the identification, at the time of admission and possibly before the occurrence of a DRP, of patients at higher risk of requiring a pharmaceutical intervention later during their hospital stay. To optimize patient care, clinical pharmacists should closely follow inpatients with electrolyte imbalance, polypharmacy, and/or use of systemic antibacterials. RÉSUMÉ Contexte : Les interventions pharmaceutiques visent à corriger ou à prévenir un problème lié aux drogues (PLD), qui pourrait entraîner des conséquences cliniques négatives et accroître les coûts des soins de santé. Objectif : Déterminer les variables associées aux interventions pharmaceutiques des pharmaciens cliniques lors d’une hospitalisation. Méthodes : Dans cette étude de cohorte rétrospective, les patients adultes hospitalisés au Service de médecine de l’Hôpital universitaire de São Paulo au Brésil ont été suivis dès leur admission et jusqu’à leur sortie. Des modèles de régression logistique ont été utilisés pour évaluer l’association entre au moins une intervention pharmaceutique et les caractéristiques de base suivantes : sexe, âge, indice de comorbidité de Charlson, insuffisance rénale, déséquilibre électrolytique, hémoglobine, numération plaquettaire et utilisation d’un tube nasoentérique, et l’ensemble du groupe a subi une évaluation selon le nombre de médicaments prescrits au deuxième niveau des classifications du Système de classification anatomique thérapeutique chimique (ATC) et leur voie d’administration. Résultats : Cent-quarante-huit (148) patients ont été inclus dans cette étude; 75 d’entre eux (50,7 %) étaient des hommes. L’âge moyen était de 62,8 ans (95 % intervalle de confiance [IC] 59,9 - 65,8), et la durée moyenne du séjour à l’hôpital était de 10,7 jours (95 % IC 8,4 – 13,1). Des analgésiques (code ATC N02), type de médicament le plus répandu, ont été prescrits à 144 patients (97,3 %). Seuls 49 patients (33,1 %) ont fait l’objet d’une intervention pharmaceutique. Une de ces interventions sur quatre avait pour but d’obtenir des informations absentes dans la prescription mais indispensables à l’obtention de la validation de la prescription et de l’autorisation de distribution des médicaments. Selon l’analyse multivariée, le rapport de cotes (RC) de la nécessité d’au moins une intervention pharmaceutique augmentait pour les patients ayant un déséquilibre électrolytique (RC 2,68, 95 % IC 1,09 - 6,63; p = 0,033), les patients prenant entre cinq et huit médicaments (RC 8,73, 95 % IC 1,07 - 71,36; p = 0,043), les patients prenant au moins neuf médicaments (RC 10,39, 95 % IC 1,28 - 84,05; p = 0,028) et ceux utilisant au moins un antibactérien systémique (code ATC J01; RC 2,76, 95 % IC 1,30–5,84; p = 0,008). Conclusions : Les résultats de cette étude pourraient permettre d’identifier, à l’admission à l’hôpital et probablement avant l’apparition d’un PLD, les patients présentant des risques plus élevés, qui pourraient nécessiter une intervention pharmaceutique plus tard lors de leur séjour. Pour optimiser les soins aux patients, les pharmaciens cliniques doivent suivre étroitement les patients hospitalisés ayant un déséquilibre électrolytique, ceux qui nécessitent une polypharmacie et ceux qui utilisent des antibactériens systémiques.

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“…Além dessas causas, os EA relacionados a medicamentos também são significativos nos cuidados à saúde, correspondendo a 45% dos EA relacionados a medicamentos ou substâncias medicinais em uso terapêutico nos EUA. (27) Os resultados evidenciam que a falha em processos e atividades, ou o não seguimento de protocolos e recomendações estão relacionados à ocorrência de EA. (28) Os estudos analisados trazem como causas da ocorrência de eventos adversos falhas na comunicação, (16,19) falha no registro de informações em sistemas e documentos, (19,20) além de erros na transcrição de informações e resultados laboratoriais e de imunologia; (19) erros de conformidade, isto é, falhas no não seguimento de rotinas e protocolos; (20) erros na tomada de decisão; (20) erros no gerenciamento da fila de espera; (20) erros de rotulagem dos órgãos ou tecidos doados.…”

Section: Discussionunclassified

Biovigilância e notificação de eventos adversos na doação e transplante de órgãos: revisão sistemática

Roza¹,

Lazarini²,

Treviso³

et al. 2023

Acta Paulista De Enfermagem

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Association of Adverse Drug Events with Hospitalization Outcomes and Costs in Older Adults in the USA using the Nationwide Readmissions Database

Cited by 8 publications

References 13 publications

Characteristics of Older Adults Who Were Early Adopters of Medical Cannabis in the Florida Medical Marijuana Use Registry

Characteristics of Older Adults Who Were Early Adopters of Medical Cannabis in the Florida Medical Marijuana Use Registry

Patient Factors Associated with Pharmaceutical Interventions for Inpatients at a Brazilian Teaching Hospital

Biovigilância e notificação de eventos adversos na doação e transplante de órgãos: revisão sistemática

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