(097) Adverse Drug Reactions in an Ageing PopulaTion (ADAPT) study: Prevalence and risk factors associated with adverse drug reaction-related hospital admissions in older patients
PhD Candidate School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland. Dublin, Ireland
Background: Older people experience greater morbidity with a corresponding increase in medication use resulting in a potentially higher risk of adverse drug reactions (ADRs).
Objectives: The aim of this study was to; (i) determine the prevalence and characteristics of ADR-related hospital admissions among older patients (≥65 years) in Ireland; and (ii) identify the risk factors associated with ADR-related hospital admissions.
Methods: A cross-sectional study of ADR prevalence in patients aged ≥65 years admitted acutely to hospital in Ireland over 8 months (November 2016- June 2017). A multifaceted review of each admission was undertaken to assess the likelihood of an ADR being causal or contributing to admission in the context of the patient’s medication, clinical conditions, comorbidities and investigations. Two independent reviewers applied decision aids to assess ADR causality, avoidability and severity. Multivariable logistic regression was used to assess the association between potential risk factors for ADR-related admissions and non-ADR-related admissions.
Results: In total, 3,760 hospital admissions (in 3091 patients) were screened and 377 were considered ADR-related (10.0%, 95% CI 9.1%,11.0%). 219 (58.1%) ADR-related admissions were caused by an ADR, while ADRs contributed to 158 (41.9%) admissions. 268 (71.1%) of all ADR-related admissions were deemed definitely or possibly preventable/avoidable. 350 (92.8%) ADRs were classified as moderate severity and 27 (7.2%) as severe. Antithrombotic agents, mainly aspirin and warfarin, were the drugs most frequently associated with ADR-related admissions. In multivariate analysis, immobility, frailty, having delirium or ulcer disease and taking anticoagulants and antiplatelets on admission were significantly associated with ADR-related admissions
Conclusions: One in ten hospital admissions were considered ADR-related. Reliable and validated ADR detection and prediction tools are needed to develop prevention strategies.
