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dc.contributor.authorLavan, Amanda
dc.contributor.authorEustace, Joseph
dc.contributor.authorDahly, Darren
dc.contributor.authorFlanagan, Evelyn
dc.contributor.authorGallagher, Paul
dc.contributor.authorCullinane, Shane
dc.contributor.authorPetrovic, Mirko
dc.contributor.authorPerehudoff, Katrina
dc.contributor.authorGudmondsson, Adalsteinn
dc.contributor.authorSamuelsson, Ólafur
dc.contributor.authorSverrisdóttir, Ástrós
dc.contributor.authorCherubin, Antonio
dc.contributor.authorDimitri, Frederica
dc.contributor.authorRimland, Joe
dc.contributor.authorCruz-Jentoft, Alfonso
dc.contributor.authorVélez-Díaz-Pallarés, Manuel
dc.contributor.authorLozano Montoya, Isabel
dc.contributor.authorSoiza, Roy L.
dc.contributor.authorSubbarayan, Selvarani
dc.contributor.authorO’Mahony, Denis
dc.date.accessioned2018-01-31T15:49:38Z
dc.date.available2018-01-31T15:49:38Z
dc.date.issued2017-10-24
dc.date.submitted2018
dc.identifier.citationIncident adverse drug reactions in geriatric inpatients: a multicentred observational study 2017, 9 (1):13 Therapeutic Advances in Drug Safetyen
dc.identifier.issn2042-0986
dc.identifier.issn2042-0994
dc.identifier.doi10.1177/2042098617736191
dc.identifier.urihttp://hdl.handle.net/2336/620446
dc.descriptionTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Filesen
dc.description.abstractBACKGROUND: Adverse drug reactions (ADRs) are common in older adults and frequently have serious clinical and economic consequences. This study was conducted as a feasibility study for a randomized control trial (RCT) that will investigate the efficacy of a software engine to optimize medications and reduce incident (in-hospital) ADRs. This study's objectives were to (i) establish current incident ADR rates across the six sites participating in the forthcoming RCT and (ii) assess whether incident ADRs are predictable. METHODS: This was a multicentre, prospective observational study involving six European hospitals. Adults aged ⩾ 65 years, hospitalized with an acute illness and on pharmacological treatment for three or more conditions were eligible for inclusion. Adverse events (AEs) were captured using a trigger list of 12 common ADRs. An AE was deemed an ADR when its association with an administered drug was adjudicated as being probable/certain, according to the World Health Organization Uppsala Monitoring Centre causality assessment. The proportion of patients experiencing at least one, probable/certain, incident ADR within 14 days of enrolment/discharge was recorded. RESULTS: A total of 644 patients were recruited, evenly split by sex and overwhelmingly of White ethnicity. Over 80% of admissions were medical. The median number of chronic conditions was five (interquartile range 4-6), with eight or more conditions present in approximately 10%. The mean number of prescribed medications was 9.9 (standard deviation 3.8), which correlated strongly with the number of conditions (r = 0.54, p < 0.0001). A total of 732 AEs were recorded in 382 patients, of which 363 were incident. The majority of events were classified as probably or possibly drug related, with heterogeneity across sites (χ2 = 88.567, df = 20, p value < 0.001). Out of 644 patients, 139 (21.6%; 95% confidence interval 18.5-25.0%) experienced an ADR. Serum electrolyte abnormalities were the most common ADR. The ADRROP (ADR Risk in Older People) and GerontoNet ADR risk scales correctly predicted ADR occurrence in 61% and 60% of patients, respectively. CONCLUSION: This feasibility study established the rates of incident ADRs across the six study sites. The ADR predictive power of ADRROP and GerontoNet ADR risk scales were limited in this population.
dc.description.sponsorshipEuropean Commission's Seventh Framework Programme SENATOR project EC under Horizonen
dc.language.isoenen
dc.publisherSAGE Publicationsen
dc.relation.urlhttp://journals.sagepub.com/doi/10.1177/2042098617736191en
dc.rightsArchived with thanks to Therapeutic Advances in Drug Safetyen
dc.subjectAukaverkanir lyfjaen
dc.subjectAldraðiren
dc.subjectSjúkrahúsen
dc.subjectGER12en
dc.subject.meshDrug-Related Side Effects and Adverse Reactionsen
dc.subject.meshAgeden
dc.subject.meshInpatientsen
dc.subject.meshMultimorbidityen
dc.titleIncident adverse drug reactions in geriatric inpatients: a multicentred observational studyen
dc.typeArticleen
dc.contributor.department[ 1 ] Univ Coll Cork, Dept Med, Cork, Ireland Show more [ 2 ] Cork Univ Hosp, Dept Geriatr Med, Cork, Ireland Show more [ 3 ] Natl Univ Ireland, Dept Med, Univ Coll Cork, Cork, Ireland Show more [ 4 ] Natl Univ Ireland, Univ Coll Cork, Dept Epidemiol, Cork, Ireland Show more [ 5 ] Clin Res Facil, Hlth Res Board, Cork, Ireland Show more [ 6 ] Natl Univ Ireland, Univ Coll Cork, Dept Pharm, Cork, Ireland Show more [ 7 ] Univ Ghent, Dept Internal Med, Sect Geriatr, Ghent, Belgium Show more [ 8 ] Univ Ghent, Ghent, Belgium Show more [ 9 ] Landspitali Univ Hosp, Dept Geriatr Med, Reykjavik, Iceland Show more [ 10 ] IRCCS INRCA, Geriatria & Accettaz Geriatr Urgenza, Ancona, Italy Show more [ 11 ] Hosp Univ Ramon & Cajal IRYCIS, Madrid, Spain Show more [ 12 ] Hosp Univ Ramon & Cajal, Madrid, Spain [ 13 ] NHS Grampian, Aberdeen, Scotland Show more [ 14 ] Univ Aberdeen, Sch Med & Dent, Aberdeen, Scotlanden
dc.identifier.journalTherapeutic Advances in Drug Safetyen
dc.rights.accessOpen Access - Opinn aðganguren
dc.contributor.institutionDepartment of Medicine, University College Cork National University of Ireland, Cork, Ireland
dc.contributor.institutionDepartment of Medicine, University College Cork National University of Ireland, Cork, Ireland
dc.contributor.institutionDepartment of Epidemiology, University College Cork National University of Ireland, Cork, Ireland
dc.contributor.institutionHealth Research Board Clinical Research Facility, Ireland
dc.contributor.institutionDepartment of Medicine, University College Cork National University of Ireland, Cork, Ireland
dc.contributor.institutionDepartment of Pharmacy, University College Cork National University of Ireland, Cork, Ireland
dc.contributor.institutionDepartment of Internal Medicine, Section of Geriatrics, Universiteit Gent, Gent, Belgium
dc.contributor.institutionUniversiteit Gent, Gent, Belgium
dc.contributor.institutionDepartment of Geriatric Medicine, Landspitali University Hospital, Reykjavik, Iceland
dc.contributor.institutionDepartment of Geriatric Medicine, Landspitali University Hospital, Reykjavik, Iceland
dc.contributor.institutionDepartment of Geriatric Medicine, Landspitali University Hospital, Reykjavik, Iceland
dc.contributor.institutionGeriatria ed Accettazione Geriatrica d’urgenza, IRCCS-INRCA, Ancona, Italy
dc.contributor.institutionGeriatria ed Accettazione Geriatrica d’urgenza, IRCCS-INRCA, Ancona, Italy
dc.contributor.institutionGeriatria ed Accettazione Geriatrica d’urgenza, IRCCS-INRCA, Ancona, Italy
dc.contributor.institutionHospital Universitario Ramón y Cajal (IRYCIS), Spain
dc.contributor.institutionHospital Universitario Ramón y Cajal (IRYCIS), Spain
dc.contributor.institutionHospital Universitario Ramón y Cajal, Madrid, Spain
dc.contributor.institutionNHS Grampian, Aberdeen, UK
dc.contributor.institutionUniversity of Aberdeen School of Medicine and Dentistry, Aberdeen, UK
dc.contributor.institutionDepartment of Medicine, University College Cork & Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland
dc.departmentcodeGER12
refterms.dateFOA2018-09-12T16:58:58Z
html.description.abstractBACKGROUND: Adverse drug reactions (ADRs) are common in older adults and frequently have serious clinical and economic consequences. This study was conducted as a feasibility study for a randomized control trial (RCT) that will investigate the efficacy of a software engine to optimize medications and reduce incident (in-hospital) ADRs. This study's objectives were to (i) establish current incident ADR rates across the six sites participating in the forthcoming RCT and (ii) assess whether incident ADRs are predictable. METHODS: This was a multicentre, prospective observational study involving six European hospitals. Adults aged ⩾ 65 years, hospitalized with an acute illness and on pharmacological treatment for three or more conditions were eligible for inclusion. Adverse events (AEs) were captured using a trigger list of 12 common ADRs. An AE was deemed an ADR when its association with an administered drug was adjudicated as being probable/certain, according to the World Health Organization Uppsala Monitoring Centre causality assessment. The proportion of patients experiencing at least one, probable/certain, incident ADR within 14 days of enrolment/discharge was recorded. RESULTS: A total of 644 patients were recruited, evenly split by sex and overwhelmingly of White ethnicity. Over 80% of admissions were medical. The median number of chronic conditions was five (interquartile range 4-6), with eight or more conditions present in approximately 10%. The mean number of prescribed medications was 9.9 (standard deviation 3.8), which correlated strongly with the number of conditions (r = 0.54, p < 0.0001). A total of 732 AEs were recorded in 382 patients, of which 363 were incident. The majority of events were classified as probably or possibly drug related, with heterogeneity across sites (χ2 = 88.567, df = 20, p value < 0.001). Out of 644 patients, 139 (21.6%; 95% confidence interval 18.5-25.0%) experienced an ADR. Serum electrolyte abnormalities were the most common ADR. The ADRROP (ADR Risk in Older People) and GerontoNet ADR risk scales correctly predicted ADR occurrence in 61% and 60% of patients, respectively. CONCLUSION: This feasibility study established the rates of incident ADRs across the six study sites. The ADR predictive power of ADRROP and GerontoNet ADR risk scales were limited in this population.


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