title: Inappropriate medication is a major cause of adverse drug reactions in elderly patients.
abstract: To determine the extent to which adverse drug reactions (ADRs) in elderly patients admitted to hospital are due to inappropriate prescribing, we examined 416 successive admissions of elderly patients to a teaching hospital. Interacting drug combinations and drugs with relative contra-indications (CIs) were common, but not as important in producing ADRs as drugs with absolute CIs or unnecessary drugs. Forty-eight patients (11.5% of admissions) were taking a total of 51 drugs with absolute CIs (3.8% of prescriptions). One hundred and seventy-five drugs were discontinued on or shortly after admission in 113 (27%) patients because they were deemed to be unnecessary. One hundred and three patients (27.0% of those on medication) experienced 151 ADRs of which 75 (49.7%) were due to drugs with absolute CIs and/or that were unnecessary, a significantly higher rate of ADRs (p less than 0.001) than observed for all prescriptions. Of 26 (6.3%) admissions attributed to ADRs, 13 (50%) were due to inappropriate prescriptions. The admission rate per prescription was significantly higher (p less than 0.001) for inappropriate than for appropriate drugs. We conclude that much drug-related morbidity in the elderly population may be avoidable, as it is due to inappropriate prescribing.
authors.affiliation: Tameside General Hospital, Ashton under Lyne.
authors.forename: C M
authors.initials: CM
authors.lastname: Lindley
authors.forename: M P
authors.initials: MP
authors.lastname: Tully
authors.forename: V
authors.initials: V
authors.lastname: Paramsothy
authors.forename: R C
authors.initials: RC
authors.lastname: Tallis
mesh_terms: D000368:Aged; D000075202:Contraindications; D004342:Drug Hypersensitivity / Q000209:etiology*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D008508:Medication Errors; D004364:Pharmaceutical Preparations; D012307:Risk Factors
chemical_list: D004364:Pharmaceutical Preparations