AIM: To study the occurrence of adverse drug reactions (ADRs) linked to inappropriate medication (IM) use in elderly people admitted to an acute medical geriatric unit. METHODS: All the elderly people aged > or = 70 years admitted to the acute medical geriatric unit of Limoges University hospital (France) over a 49-month period were included, whatever their medical condition. For all the patients, clinical pharmacologists listed the medications given before admission and identified the possible ADRs. The appropriateness of these medications and the causal relationship between drugs (either appropriate or not) and ADRs were evaluated. RESULTS: Two thousand and eighteen patients were included. The number of drugs taken was 7.3 +/- 3.0 in the patients with ADRs and 6.0 +/- 3.0 in those without ADRs (P < 0.0001). Sixty-six percent of the patients were given at least one IM prior to admission. ADR prevalence was 20.4% among the 1331 patients using IMs and 16.4% among those using only appropriate drugs (P < 0.03). In only 79 of the 1331 IM users (5.9%) were ADRs directly attributable to IMs. The IMs most often involved in patients with ADRs were: anticholinergic antidepressants, cerebral vasodilators, long-acting benzodiazepines and concomitant use of two or more psychotropic drugs from the same therapeutic class. Using multivariate analysis, after adjusting for confounding factors, IM use was not associated with a significant increased risk of ADRs (odds ratio 1.0, 95% confidence interval 0.8, 1.3). CONCLUSION: Besides a reduction in the number of drugs given to the elderly, a good prescription should involve a reduction in the proportion of IMs and should take into consideration the frailty of these patients.
AIM: To study the occurrence of adverse drug reactions (ADRs) linked to inappropriate medication (IM) use in elderly people admitted to an acute medical geriatric unit. METHODS: All the elderly people aged > or = 70 years admitted to the acute medical geriatric unit of Limoges University hospital (France) over a 49-month period were included, whatever their medical condition. For all the patients, clinical pharmacologists listed the medications given before admission and identified the possible ADRs. The appropriateness of these medications and the causal relationship between drugs (either appropriate or not) and ADRs were evaluated. RESULTS: Two thousand and eighteen patients were included. The number of drugs taken was 7.3 +/- 3.0 in the patients with ADRs and 6.0 +/- 3.0 in those without ADRs (P < 0.0001). Sixty-six percent of the patients were given at least one IM prior to admission. ADR prevalence was 20.4% among the 1331 patients using IMs and 16.4% among those using only appropriate drugs (P < 0.03). In only 79 of the 1331 IM users (5.9%) were ADRs directly attributable to IMs. The IMs most often involved in patients with ADRs were: anticholinergic antidepressants, cerebral vasodilators, long-acting benzodiazepines and concomitant use of two or more psychotropic drugs from the same therapeutic class. Using multivariate analysis, after adjusting for confounding factors, IM use was not associated with a significant increased risk of ADRs (odds ratio 1.0, 95% confidence interval 0.8, 1.3). CONCLUSION: Besides a reduction in the number of drugs given to the elderly, a good prescription should involve a reduction in the proportion of IMs and should take into consideration the frailty of these patients.
Authors: Joseph T Hanlon; Gerda G Fillenbaum; Maggie Kuchibhatla; Margaret B Artz; Chad Boult; Cynthia R Gross; Judith Garrard; Kenneth E Schmader Journal: Med Care Date: 2002-02 Impact factor: 2.983
Authors: J H Gurwitz; T S Field; J Avorn; D McCormick; S Jain; M Eckler; M Benser; A C Edmondson; D W Bates Journal: Am J Med Date: 2000-08-01 Impact factor: 4.965
Authors: Kirkwood F Adams; J Herbert Patterson; Wendy A Gattis; Christopher M O'Connor; Craig R Lee; Todd A Schwartz; Mihai Gheorghiade Journal: J Am Coll Cardiol Date: 2005-08-02 Impact factor: 24.094
Authors: Eva Blozik; Andreas M Born; Andreas E Stuck; Ulrich Benninger; Gerhard Gillmann; Kerri M Clough-Gorr Journal: Drugs Aging Date: 2010-12-01 Impact factor: 3.923
Authors: Markus Gosch; Birgit Böhmdorfer; Ursula Benvenuti-Falger; Peter Dovjak; Bernhard Iglseder; Monika Lechleitner; Ronald Otto; Regina E Roller; Ulrike Sommeregger Journal: Wien Med Wochenschr Date: 2010-06