Abstract
Objective: The process of aging involves an individual’s structural and functional depravity of their organ systems often results in compromised pharmacological principles of the prescribed drugs. Multimorbidity and polypharmacy along with change in pharmacokinetic and pharmacodynamic responses of drugs predispose the elderly to adverse drug reactions (ADRs). The present study was aimed to identify and report the characteristics and incidence of ADRs among geriatrics in an outpatient clinic.
 Methods: This was a 6-month prospective hospital-based observational study among patients of either sex aged 60 years and above visiting an outpatient clinic at the study site. The suspected ADRs were categorized according to the Will’s and Brown classification system. Causality of these ADRs was verified by applying the WHO-UMC criteria and the Naranjo’s scale. Severity and preventability of the ADRs were classified using the modified Hartwig and Siegel scale and modified Schumock and Thornton scale, respectively. Multivariate logistic regression was used to determine the risk factors for developing ADRs.
 Results: Among the 365 patients monitored, 57 (15%) patients experienced 60 ADRs. Therapeutic classes of drugs frequently associated with ADRs were the drugs used in hypertension (27 [45%]). Patients presenting with amlodipine (9 [15%]) induced pedal edema were observed with the highest frequency of ADRs. Polypharmacy (OR: 1.619, 95% confidence interval: 0.957−2.741, p=0.021) was observed as the influential risk factor for ADRs.
 Conclusion: Pharmacist’s services and involvement in geriatric patient’s centered care can be associated with their improved health, quality of life and economic outcomes, a reduction in medicine-related adverse events, and limiting the morbidity and mortality in this age band.
Highlights
The 21st century has witnessed a significant and distinctive global demographic phase called “population aging” [1]
The previous studies have found that those presenting with an adverse drug reactions (ADRs) have an extended hospital stay and succeeding outpatient health service use which is of higher rate than those without ADRs [15,16]
Causality of ADRs was verified by applying the World Health Organization-Uppsala Monitoring Centre (WHOUMC) scale and Naranjo’s criteria
Summary
The 21st century has witnessed a significant and distinctive global demographic phase called “population aging” [1]. Studies conducted have suggested ADR-related hospital admissions at a rate of 10% and 11% in geriatrics [10,11]. They account for almost two-thirds of all drug-related hospital admissions and emergency department visits [12,13]. In a developing country like India, the coverage of insurance policies is limited and increasing out of pocket medical expenses resulting in economic burden. They have important consequences and one-third of such events are preventable or ameliorable. Active pharmacovigilance (PV) surveillance activities, spontaneous reporting of ADRs, and conducting observational studies are important tools for identification, evaluation, and prevention of ADRs, minimalizing the financial burden on the victims
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