Risk factors for adverse drug events in hospitalized elderly patients: A geriatric score

Trivalle, C.; Burlaud, Antony; Ducimetière, Pierre

doi:10.1016/j.eurger.2011.07.002

Cited by 55 publications

(142 citation statements)

References 23 publications

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“…Among the main drug intoxications that resulted in hospitalization, were cases arising from the consumption of analgesics, antipyretics and antirheumatics, non-opioid, corroborating the findings of other studies (Srivastava et al, 2005;Trivalle et al, 2011).…”

Section: T H E V E R I F I C a T I O N T H A T T H E O C C U R R E N supporting

confidence: 79%

“…A n t i c o n v u l s a n t s , s e d a t i v e s , h y p n o t i c s , antiparkinsonian and psychotropic NEC were the most recorded in this study, in disagreement with the study of Trivalle et al (2011) which found this class of drugs contributed to 37.3% of hospital admissions in the elderly. However, the combination of antipsychotics and anticoagulants accounted for around 50% of these cases.…”

Section: T H E V E R I F I C a T I O N T H A T T H E O C C U R R E N contrasting

confidence: 55%

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Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

Abreu

Ferreira

et al. 2013

Braz. J. Pharm. Sci.

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A cross-sectional study of secondary data/information obtained from the Hospital Information System (HIS) spanning the years 2008 -2009 was performed. The distribution of the main hospital admissions by gender, age, color/race, region and federal unit of residence, average expenditure and average length of hospital stay, year of hospitalization and mortality rates (MR) were studied. The data collected were tabulated by TabNet and keyed into Microsoft Excel 2007. It was verified that elderly males (54.3%), from 60 to 69 years old (50.6%), nonwhites (36.3%) and residents of Southeast and North regions of the country had the highest rates of hospitalization. Seniors were hospitalized for an average of 4.8 days, and the major causes were exposure to alcohol (43.7%) and to drugs (33.9%). Expenses related to hospital admissions were, on average, R$ 529,817.70. The highest mortality rates were recorded among females (MR = 4.34), in elderly, 80 years or older (MR = 10.16) and Caucasians (MR = 3.95), where pharmacological substances with action on the Autonomic Nervous System were the leading cause of death. There are demographic differences in morbi-mortality of these elderly since, although men and younger elderly were the main victims, women and elderly of advanced age have greater mortality. The leading causes of hospitalization were alcohol and drugs.Uniterms: Hospital Information System. Elderly patients/hospitalization. Medicines/inappropriated use. Hospitalization/rates. Poisoning. Alcohol/use.Realizou-se um estudo transversal de dados secundários obtidos no Sistema de Informação Hospitalar (SIH), nos anos 2008/2009. Estudou-se a distribuição das principais internações segundo sexo; faixa etária; cor/ raça; região e unidade federativa de residência; valor médio pago e média de permanência das internações hospitalares; ano de internação e as taxas de mortalidade (TM). Os dados coletados foram tabulados por meio do TabNet e transcritos para o Programa Microsoft Excel® 2007. Verificou-se que idosos do sexo masculino (54,3%), com 60 e 69 anos de idade (50,6%), não brancos (36,3%) e residentes nas regiões Sudeste e Norte do País apresentaram os maiores percentuais de internação hospitalar. Idosos ficam em média 4,8 dias internados, sendo as principais causas a exposição ao álcool (43,7%) e a medicamentos (33,9%). Os gastos com as internações equivaleram a R$ 529.817,70. As maiores taxas de mortalidade foram registradas no sexo feminino (TM=4,34), em idosos entre 80 anos e superior (TM=10,16) e pessoas brancas (TM=3,95), sendo as substâncias farmacológicas de ação sobre o Sistema Nervoso Autônomo maiores causas do óbito. Existem diferenças demográficas na morbimortalidade desses idosos, visto que apesar de homens e idosos mais jovens serem as principais vítimas, mulheres e idosos com idade mais avançada morrem mais. Sendo as principais causas de internação o álcool e os medicamentos.Unitermos: Sistema de Informação Hospitalar Paciente idosos/hospitalização. Medicamentos/uso inapropriado. Hospitalização/causas. Envenena...

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Section: T H E V E R I F I C a T I O N T H A T T H E O C C U R R E N supporting

confidence: 79%

Section: T H E V E R I F I C a T I O N T H A T T H E O C C U R R E N contrasting

confidence: 55%

Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

Abreu

Ferreira

et al. 2013

Braz. J. Pharm. Sci.

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“…The majority of these (535) were excluded on review of their abstract as they were not associated with the design of a risk prediction model; many of these were observational (see Figure 1). Full papers were requested for the remaining 14 articles for further scrutiny, and four met the inclusion criteria and were subjected to a full evaluation 12–15…”

Section: Resultsmentioning

confidence: 99%

“…Onder et al extracted 3 years of data from a historical database, whereas data were extracted over 1–6 months in the other studies. Patient medical notes, in-patient charts, and electronic records were reviewed in the prospective studies 12,13,15. In addition, McElnay12 asked a sample of the patients about aspects of their medicines, while Trivalle et al15 used patient self-reporting as a trigger for further analysis.…”

Section: Model Developmentmentioning

confidence: 99%

Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models

Jm¹,

Jl²,

Tg³

et al. 2014

CIA

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Adverse drug reaction (ADR) risk-prediction models for use in older adults have been developed, but it is not clear if they are suitable for use in clinical practice. This systematic review aimed to identify and investigate the quality of validated ADR risk-prediction models for use in older adults. Standard computerized databases, the gray literature, bibliographies, and citations were searched (2012) to identify relevant peer-reviewed studies. Studies that developed and validated an ADR prediction model for use in patients over 65 years old, using a multivariable approach in the design and analysis, were included. Data were extracted and their quality assessed by independent reviewers using a standard approach. Of the 13,423 titles identified, only 549 were associated with adverse outcomes of medicines use. Four met the inclusion criteria. All were conducted in inpatient cohorts in Western Europe. None of the models satisfied the four key stages in the creation of a quality risk prediction model; development and validation were completed, but impact and implementation were not assessed. Model performance was modest; area under the receiver operator curve ranged from 0.623 to 0.73. Study quality was difficult to assess due to poor reporting, but inappropriate methods were apparent. Further work needs to be conducted concerning the existing models to enable the development of a robust ADR risk-prediction model that is externally validated, with practical design and good performance. Only then can implementation and impact be assessed with the aim of generating a model of high enough quality to be considered for use in clinical care to prioritize older people at high risk of suffering an ADR.

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“…Four tools were identified from the literature; three related to ADRs [Onder et al 2010;Tangiisuran 2009;McElnay et al 1997] and one related to ADEs [Trivalle et al 2011]. The three ADR prediction tools included dedicated development and validation phases but none addressed clinical impact or implementation, thereby limiting universal applicability.…”

Section: Adr Prediction Toolsmentioning

confidence: 99%

Predicting risk of adverse drug reactions in older adults

Lavan

Gallagher

2015

Therapeutic Advances in Drug Safety

338

241

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Adverse drug reactions (ADRs) are common in older adults, with falls, orthostatic hypotension, delirium, renal failure, gastrointestinal and intracranial bleeding being amongst the most common clinical manifestations. ADR risk increases with age-related changes in pharmacokinetics and pharmacodynamics, increasing burden of comorbidity, polypharmacy, inappropriate prescribing and suboptimal monitoring of drugs. ADRs are a preventable cause of harm to patients and an unnecessary waste of healthcare resources. Several ADR risk tools exist but none has sufficient predictive value for clinical practice. Good clinical practice for detecting and predicting ADRs in vulnerable patients includes detailed documentation and regular review of prescribed and over-the-counter medications through standardized medication reconciliation. New medications should be prescribed cautiously with clear therapeutic goals and recognition of the impact a drug can have on multiple organ systems. Prescribers should regularly review medication efficacy and be vigilant for ADRs and their contributory risk factors. Deprescribing should occur at an individual level when drugs are no longer efficacious or beneficial or when safer alternatives exist. Inappropriate prescribing and unnecessary polypharmacy should be minimized. Comprehensive geriatric assessment and the use of explicit prescribing criteria can be useful in this regard.

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Risk factors for adverse drug events in hospitalized elderly patients: A geriatric score

Cited by 55 publications

References 23 publications

Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models

Predicting risk of adverse drug reactions in older adults

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