Abstract
BackgroundEpidemiologic information on time trends of Adverse Drug Reactions (ADR) and ADR-related hospitalizations is scarce. Over time, pharmacotherapy has become increasingly complex. Because of raised awareness of ADR, a decrease in ADR might be expected. The aim of this study was to determine trends in ADR-related hospitalizations in the older Dutch population.Methodology and Principal FindingsSecular trend analysis of ADR-related hospital admissions in patients ≥60 years between 1981 and 2007, using the National Hospital Discharge Registry of the Netherlands. Numbers, age-specific and age-adjusted incidence rates (per 10,000 persons) of ADR-related hospital admissions were used as outcome measures in each year of the study. Between 1981 and 2007, ADR-related hospital admissions in persons ≥60 years increased by 143%. The overall standardized incidence rate increased from 23.3 to 38.3 per 10,000 older persons. The increase was larger in males than in females. Since 1997, the increase in incidence rates of ADR-related hospitalizations flattened (percentage annual change 0.65%), compared to the period 1981–1996 (percentage annual change 2.56%).Conclusion/SignificanceADR-related hospital admissions in older persons have shown a rapidly increasing trend in the Netherlands over the last three decades with a temporization since 1997. Although an encouraging flattening in the increasing trend of ADR-related admissions was found around 1997, the incidence is still rising, which warrants sustained attention to this problem.
Highlights
Medication use among older persons has grown over the last decades.[1]
The total number of ADRrelated hospital admissions in the Dutch population aged $60 years increased from 5,291 admissions in 1981 to 12,836 in 2007 (Figure 1)
This study shows that both the absolute numbers and the incidence rates of Adverse Drug Reactions (ADR)-related hospitalizations in persons aged $60 years in the Netherlands increased strongly between 1981 and 2007
Summary
Medication use among older persons has grown over the last decades.[1] Pharmacotherapy has become increasingly complex[2] due to growing knowledge about disease pathophysiology, discovery of new drug therapies over time, and secondary preventive therapies, usually laid down in guidelines or protocols.[3] In 2007, persons aged $65 years constituted 14.4% of the Dutch population, whereas 44% of all drug prescriptions was for this age-group.[4] This is not surprising, as older persons in general have the highest prevalence of chronic and multiple (comorbid) diseases. Even when medication is prescribed in the recommended doses according to the guidelines,[3] Adverse Drug Reactions (ADR) can occur. Epidemiologic information on time trends of Adverse Drug Reactions (ADR) and ADR-related hospitalizations is scarce. The aim of this study was to determine trends in ADR-related hospitalizations in the older Dutch population
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