TY - JOUR
T1 - Risk factors for adverse drug reactions in older inpatients of geriatric wards at admission
T2 - Multicenter study
AU - Kojima, Taro
AU - Matsui, Toshifumi
AU - Suzuki, Yusuke
AU - Takeya, Yasushi
AU - Tomita, Naoki
AU - Kozaki, Koichi
AU - Kuzuya, Masafumi
AU - Rakugi, Hiromi
AU - Arai, Hiroyuki
AU - Akishita, Masahiro
N1 - Funding Information:
The authors thank all physicians and staff at the five university hospitals who contributed to registering the records of the inpatients. This study was financially supported by a research grant from the Japan Agency for Medical Research and Development (AMED; 15dk0107001h0003).
Funding Information:
MA received remuneration from Astellas Pharma, Boehringer Ingelheim, Daiichi Sankyo, Eisai, Eli Lilly Japan, Mitsubishi‐Tanabe Pharma, Mochida Pharmaceutical, MSD, Pfizer Japan, Sumitomo Dainippon Pharma, Takeda Pharmaceutical and Ono Pharmaceutical, and research funding from Astellas Pharma, AstraZeneca, Bayer HealthCare, Boehringer Ingelheim, Chugai Pharmaceutical, Daiichi Sankyo, Kowa Pharmaceutical, Mitsubishi‐Tanabe Pharma, Mochida Pharmaceutical, MSD, Ono Pharmaceutical, Otsuka Pharmaceutical, Pfizer Japan, Taisho Toyama Pharmaceutical, Takeda Pharmaceutical and Tsumura. The other authors declare no conflict of interest.
Publisher Copyright:
© 2019 Japan Geriatrics Society
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Aim: To investigate the characteristics of adverse drug reactions (ADR) and their risk factors among very old patients in five geriatric wards in Japan. Methods: A retrospective observational multicenter study was carried out to investigate factors related to ADR in older inpatients from geriatric wards of five university hospitals in Japan. Data including drugs profile and short-form comprehensive geriatric assessment were obtained from medical charts. ADR were identified from geriatrician's reports. For each ADR, symptoms and causal drugs were clarified, and factors associated with ADR were analyzed statistically. Results: In 1155 patients (52.5% women, mean age 82.8 ± 7.0 years), the proportion with ADR was 15.4%. There was a great variety of signs and symptoms of ADR, and a great variety of drugs suspected to be the cause of ADR. On multiple logistic regression analysis, ADR was significantly associated with an increase in drugs (odds ratio 1.11, 95% CI 1.07–1.16) and emergency admission (odds ratio 2.76, 95% CI 1.82–4.15). Receiver operating characteristic curve analysis showed that the optimal cut-off number of drugs for predicting ADR was ≥7. Conclusions: In geriatric inpatients, polypharmacy (especially ≥7 drugs) and emergency admission were associated with ADR. Because there was a great variety of ADR in the study, clinicians must consider reviewing all drugs to prevent adverse drugs reactions during admission in this vulnerable population. Geriatr Gerontol Int 2019; ••: ••–••. Geriatr Gerontol Int 2020; 20: 144–149.
AB - Aim: To investigate the characteristics of adverse drug reactions (ADR) and their risk factors among very old patients in five geriatric wards in Japan. Methods: A retrospective observational multicenter study was carried out to investigate factors related to ADR in older inpatients from geriatric wards of five university hospitals in Japan. Data including drugs profile and short-form comprehensive geriatric assessment were obtained from medical charts. ADR were identified from geriatrician's reports. For each ADR, symptoms and causal drugs were clarified, and factors associated with ADR were analyzed statistically. Results: In 1155 patients (52.5% women, mean age 82.8 ± 7.0 years), the proportion with ADR was 15.4%. There was a great variety of signs and symptoms of ADR, and a great variety of drugs suspected to be the cause of ADR. On multiple logistic regression analysis, ADR was significantly associated with an increase in drugs (odds ratio 1.11, 95% CI 1.07–1.16) and emergency admission (odds ratio 2.76, 95% CI 1.82–4.15). Receiver operating characteristic curve analysis showed that the optimal cut-off number of drugs for predicting ADR was ≥7. Conclusions: In geriatric inpatients, polypharmacy (especially ≥7 drugs) and emergency admission were associated with ADR. Because there was a great variety of ADR in the study, clinicians must consider reviewing all drugs to prevent adverse drugs reactions during admission in this vulnerable population. Geriatr Gerontol Int 2019; ••: ••–••. Geriatr Gerontol Int 2020; 20: 144–149.
KW - adverse drug reaction
KW - drug therapy
KW - polypharmacy
UR - http://www.scopus.com/inward/record.url?scp=85076416569&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076416569&partnerID=8YFLogxK
U2 - 10.1111/ggi.13844
DO - 10.1111/ggi.13844
M3 - Article
C2 - 31829506
AN - SCOPUS:85076416569
SN - 1444-1586
VL - 20
SP - 144
EP - 149
JO - Geriatrics and Gerontology International
JF - Geriatrics and Gerontology International
IS - 2
ER -