Development and Validation of a Score to Assess Risk of Adverse Drug Reactions Among In-Hospital Patients 65 Years or Older

Onder, Graziano; Petrovic, Mirko; Tangiisuran, Balamurugan; Meinardi, Marieke C; Markito-Notenboom, Winih P; Somers, Annemie; Rajkumar, Chakravarthi; Bernabei, Roberto; Cammen, Tischa J. M. van der

doi:10.1001/archinternmed.2010.153

Cited by 272 publications

(402 citation statements)

References 38 publications

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“…Indeed, the chance of an adverse drug event during the hospitalization of an older adult taking 8 or more medications is greater than 85%. 27 Medications can be safely stopped in older adults, with improved functional outcomes in the outpatient setting. 28 Reduction in polypharmacy should target three classes of medications: anticholinergics, proton pump inhibitors (PPIs), and benzodiazepine and nonbenzodiazepine hypnotics.…”

Section: Preventing Adverse Drug Events By Minimizing Polypharmacymentioning

confidence: 99%

Making Hospitals Safer for Older Adults: Updating Quality Metrics by Understanding Hospital-Acquired Delirium and Its Link to Falls

Lee

Gibbs

Fahey

et al. 2013

TPJ

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Section: Preventing Adverse Drug Events By Minimizing Polypharmacymentioning

confidence: 99%

Making Hospitals Safer for Older Adults: Updating Quality Metrics by Understanding Hospital-Acquired Delirium and Its Link to Falls

Lee

Gibbs

Fahey

et al. 2013

TPJ

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“…It has been reported that the risk factors for adverse drug reactions (ADRs) are the presence of heart failure, liver disease, the number of medications, previous ADR, renal failure, and ≥4 comorbid conditions . 21 Almost all the patients who admit to acute hospital have those problems; thus, we have to think more about ADRs.…”

Section: Discussionmentioning

confidence: 99%

Are the kind of medications and patient's background associated with improving polypharmacy in elderly?

Tomita

Kobayashi

Hayashi

et al. 2018

J of Gen and Family Med

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BackgroundPolypharmacy is associated with negative outcomes in older population. Managing polypharmacy is important but there is no definite method for regulating it. Our aim was to evaluate what medications and patient's background are associated with reducing polypharmacy.MethodsA prospective, single‐center, cohort study was conducted from June to October in 2016. Participants were 65 and older hospitalized patients. We evaluated the difference between the numbers of medications used at the time of admission and discharge for individual drug class. Univariate analyses using paired t tests were applied to evaluate reduction in prescription medications, and logistic regression was used to evaluate factors for any reduction of prescription medications used at discharge.ResultsThere were 494 subjects, and the mean of age was 79.6 ± 7.8 years. The mean number of medications used at admission was 6.9 ± 4.7 and that at discharge was 6.8 ± 4.3. The types of medications that reduced between admission and discharge were drugs for functional gastrointestinal disorders and agents acting on the renin‐angiotensin system, etc. Individual components that were strongly associated with a reduction of the number of medications used were only length of hospital stay (OR 0.99, 95% CI, 0.99‐1.0), while the number of medications on admission was related to increasing medication during hospitalization (OR 1.05, 95% CI, 1.01‐1.06).ConclusionsMost of the kinds and the number of medications prescribed might not be changed during hospitalization despite those were probably the causes of admission. The factor associated with improvements in polypharmacy was length of hospital stay.

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“…Two approaches have been recently reported in the literature which identify older patients at high risk for developing ADRs, both of which are simple and efficient: the GerontoNet ADR risk score [24] and the Brighton Adverse Drug Reactions Risk (BADRI) Model [25].…”

Section: Identification Of Older Patients At Risk For Developing Advementioning

confidence: 99%

Geriatric Pharmacotherapy: Optimisation Through Integrated Approach in the Hospital Setting

Petrovic

Somers

Onder

2016

Developing Drug Products in an Aging Society

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Since older patients are more vulnerable to adverse drug-related events, there is a need to ensure appropriate prescribing in these patients in order to prevent misuse, overuse and underuse of drugs. Different tools and strategies have been developed to reduce inappropriate prescribing; the available measures can be divided into medication assessment tools, and specific interventions to reduce inappropriate prescribing. Implicit criteria of inappropriate prescribing focus on appropriate dosing, search for drug-drug interactions, and increase adherence. Explicit criteria are consensus-based standards focusing on drugs and diseases and include lists of drugs to avoid in general or lists combining drugs with clinical data. These criteria take into consideration differences between patients, and stand for a medication review, by using a systematic approach. Different types of interventions exist in order to reduce inappropriate prescribing in older patients, such as: educational interventions, computerized decision support systems, pharmacist-based interventions, and geriatric assessment. The effects of these interventions have been studied, sometimes in a multifaceted approach combining different techniques, and all types seem to have positive effects on appropriateness of prescribing. Interdisciplinary teamwork within the integrative pharmaceutical care is important for improving of outcomes and safety of drug therapy. The pharmaceutical care process consists of four steps, which are cyclic for an individual patient. These steps are pharmaceutical anamnesis, medication review, design and follow-up of a pharmaceutical care plan. A standardized approach is necessary for the adequate detection and evaluation of drug-related problems. Furthermore, it is clear that drug therapy should be reviewed in-depth, by having full access to medical records, laboratory values and nursing notes. Although clinical pharmacists perform the pharmaceutical care process to manage the patient's drug therapy in every day clinical practice, the physician takes the ultimate responsibility for the care of the patient in close collaboration with nurses.

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Development and Validation of a Score to Assess Risk of Adverse Drug Reactions Among In-Hospital Patients 65 Years or Older

Cited by 272 publications

References 38 publications

Making Hospitals Safer for Older Adults: Updating Quality Metrics by Understanding Hospital-Acquired Delirium and Its Link to Falls

Making Hospitals Safer for Older Adults: Updating Quality Metrics by Understanding Hospital-Acquired Delirium and Its Link to Falls

Are the kind of medications and patient's background associated with improving polypharmacy in elderly?

Geriatric Pharmacotherapy: Optimisation Through Integrated Approach in the Hospital Setting

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