Do older hospital patients recognize adverse drug reactions?
OBJECTIVE
To establish the relationship between subjective complaints of side effects of drugs and the objective presence of adverse drug reactions in older patients.


METHODS
Observational cross-sectional study.


METHODS
Five medical wards at the University Hospital Rotterdam Dijkzigt.


METHODS
Patients aged 70 and over admitted to the general medical wards over a 3-month period.


METHODS
Statistical comparison and Kramer's algorithm.


RESULTS
Of 106 patients, 102 used medication, and 93 of these were able to report whether they believed they were experiencing drug side effects. Thirty-six [39% (95% confidence interval 28.8-48.6)] believed that they were experiencing side effects and the number of diagnoses per patient and the proportion of patients with chronic obstructive pulmonary disease was higher in these 36 'complainers' than in the group of the 'non-complainers'. We found a correct opinion (true positive and negative) about the objective presence or absence of mild or severe adverse drug reactions in 79% (95% confidence interval 70.2-86.8). Asking the patient about side effects of drugs had a sensitivity of 0.70 and a specificity of 0.85 patients. The severe adverse drug reactions in 21 patients were not recognized by 14 of them.


CONCLUSIONS
At hospital admission, older patients should be asked about drug side effects because they are often correct in recognizing them. However, severe adverse drug reactions are not easily recognized.
Mannesse
C K
CK
Department of Geriatric Medicine, University Hospital Rotterdam Dijkzigt, Rotterdam, The Netherlands. c.mannesse@worldonline.nl
Derkx
F H
FH
de Ridder
M A
MA
Man in 't Veld
A J
AJ
van der Cammen
T J
TJ
D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D003430:Cross-Sectional Studies; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D015577:Geriatric Assessment; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy; D008297:Male; D009426:Netherlands; D010343:Patient Admission; D010353:Patient Education as Topic