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Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay.

Publication ,  Journal Article
Hanlon, JT; Pieper, CF; Hajjar, ER; Sloane, RJ; Lindblad, CI; Ruby, CM; Schmader, KE
Published in: J Gerontol A Biol Sci Med Sci
May 2006

BACKGROUND: Adverse drug reactions (ADR) negatively impact life quality and are sometimes fatal. This study examines the incidence and predictors of all and preventable ADRs in frail elderly persons after hospital discharge, a highly vulnerable but rarely studied population. METHODS: The design was a prospective cohort study involving 808 frail elderly persons who were discharged from 11 Veteran Affairs hospitals to outpatient care. The main outcome measure was number of ADRs per patient as determined by blinded geriatrician and geropharmacist pairs using Naranjo's ADR algorithm. For all ADRs (possible, probable, or definite), preventability was assessed. Discordances were resolved by consensus conferences. RESULTS: Overall, 33% of patients had one or more ADRs for a rate of 1.92 per 1000 person-days of follow-up. The rate for preventable ADRs was 0.71 per 1000 person-days of follow-up. Independent risk factors for all ADRs were number of medications (adjusted [Adj.] hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.05-1.10 per medication), use of warfarin (Adj. HR, 1.51; 95% CI, 1.22-1.87), and (marginally) the use of benzodiazepines (Adj. HR, 1.23; 95% CI, 0.95-1.58). Counterintuitively, use of sedatives and/or hypnotics was inversely related to ADR risk (Adj. HR, 0.14; 95% CI, 0.04-0.57). Similar trends were seen for number of medications and warfarin use as predictors of preventable ADRs. CONCLUSIONS: ADRs are very common in frail elderly persons after hospital stay, and polypharmacy and warfarin use consistently increase the risk of ADRs.

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Published In

J Gerontol A Biol Sci Med Sci

DOI

ISSN

1079-5006

Publication Date

May 2006

Volume

61

Issue

5

Start / End Page

511 / 515

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Survival Analysis
  • Sex Distribution
  • Risk Assessment
  • Prospective Studies
  • Prognosis
  • Probability
  • Poisson Distribution
  • Patient Discharge
 

Citation

APA
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MLA
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Hanlon, J. T., Pieper, C. F., Hajjar, E. R., Sloane, R. J., Lindblad, C. I., Ruby, C. M., & Schmader, K. E. (2006). Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay. J Gerontol A Biol Sci Med Sci, 61(5), 511–515. https://doi.org/10.1093/gerona/61.5.511
Hanlon, Joseph T., Carl F. Pieper, Emily R. Hajjar, Richard J. Sloane, Catherine I. Lindblad, Christine M. Ruby, and Kenneth E. Schmader. “Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay.J Gerontol A Biol Sci Med Sci 61, no. 5 (May 2006): 511–15. https://doi.org/10.1093/gerona/61.5.511.
Hanlon JT, Pieper CF, Hajjar ER, Sloane RJ, Lindblad CI, Ruby CM, et al. Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay. J Gerontol A Biol Sci Med Sci. 2006 May;61(5):511–5.
Hanlon, Joseph T., et al. “Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay.J Gerontol A Biol Sci Med Sci, vol. 61, no. 5, May 2006, pp. 511–15. Pubmed, doi:10.1093/gerona/61.5.511.
Hanlon JT, Pieper CF, Hajjar ER, Sloane RJ, Lindblad CI, Ruby CM, Schmader KE. Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay. J Gerontol A Biol Sci Med Sci. 2006 May;61(5):511–515.
Journal cover image

Published In

J Gerontol A Biol Sci Med Sci

DOI

ISSN

1079-5006

Publication Date

May 2006

Volume

61

Issue

5

Start / End Page

511 / 515

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Survival Analysis
  • Sex Distribution
  • Risk Assessment
  • Prospective Studies
  • Prognosis
  • Probability
  • Poisson Distribution
  • Patient Discharge