Abstract
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital. A total number of 290 admissions were screened for ADEs, adverse drug reactions (ADRs) and drug-drug interactions (DDIs) by a multi-disciplinary research team. Customized Naranjo scale was used as a control method. All admissions were categorized into “probable,” “possible,” or “doubtful” by both assessment methods. In total, 23.1% of admissions were categorized as “probably” or “possibly” medication-related. Vertigo, falling, and fractures formed the largest group of ADEs. The most common ADEs were related to medicines from N class of the ATC-code system. Age, sex, residence, or specialty did not increase the risk for medication-related admission significantly (min p = 0.077). Polypharmacy was, however, found to increase the risk (OR 3.3; 95% CI, 1.5–6.9; p = 0.01). In conclusion, screening patients for specific demographics or symptoms would not significantly improve the recognition of ADEs. In addition, as ADE detection today is largely based on voluntary reporting systems and retrospective manual tracking of errors, it is evident that more effective methods for ADE detection are needed in the future.
Highlights
Medicating geriatric patients is a process that requires more thought and planning than medicating younger adults
The rest of the specialties were grouped as “others.” Most admissions were made by communitydwelling patients and only a minority of the patients was from institutionalized care
There are no studies published on the prevalence of geriatric hospitalizations due to Adverse drug events (ADEs) in Finland
Summary
Medicating geriatric patients is a process that requires more thought and planning than medicating younger adults. The reason for this lies partly in the physiological changes that occur with aging, e.g., changes in the body mass distribution, renal function, metabolic capacity, and alterations in blood protein levels (Mangoni and Jackson, 2003; Notenboom et al, 2014). Similar changes often increase morbidity in the aged population by weakening homeostasis and change the pharmacodynamics and pharmacokinetics of many drugs. Adverse Drug Events and Aging variation in these physiological changes increases with age. There is an evident lack in the information on drug use in the geriatric patient population
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