title: Adverse drug reactions in patients with gastroenterological diseases: does age increase the risk?
abstract: BACKGROUND
  It has been claimed that the risk of adverse drug reactions increases with age. However, only limited data exist for disease-group specific risks and none for patients with liver and gastrointestinal diseases.
  
  
  OBJECTIVE
  To determine the incidence and characteristics of adverse drug reactions and the physicians' awareness of adverse drug reactions.
  
  
  METHODS
  During a 7-month period, a prospective survey of 532 male patients (158 aged 65 years or older; 30%) was conducted on a hepatogastroenterological ward of a tertiary-care university hospital, using intensive bedside and computer-assisted drug surveillance methods.
  
  
  RESULTS
  No difference was found in the overall rate of adverse drug reactions between older and younger patients (25.9% vs. 24.2%) during 6213 treatment days. However, a significantly higher risk for developing adverse drug reactions could be shown for the elderly with biliary tract diseases (P < 0.01). Independently of age, patients suffering from gastric ulcers, acute episodes of pancreatitis, cholangitis or inflammatory bowel diseases were at high risk of adverse drug reactions. Adverse drug reaction-associated mortality was encountered in four elderly and none of the younger patients. Secondary pharmacological effects and drug toxicity were the main types of adverse drug reactions for both age groups. Although 75.3% of the adverse drug reactions were predictable, only 37.5% of all adverse drug reactions were recognized by the staff physicians.
  
  
  CONCLUSIONS
  In hepatogastroenterological patients, advancing age was not associated with an overall increased risk of adverse drug reactions except for patients with biliary tract diseases. In the elderly, adverse drug reactions were more severe and carried higher mortality. Guidelines and educational programs should be developed to increase the awareness of adverse drug reactions and their prevention, especially in high risk patients and, thus, to improve patient outcomes.
authors.affiliation: Department of Internal Medicine I, University of Erlangen-Nuremberg, Germany.harald.dormann@med1.imed.uni-erlangen.de
authors.forename: H
authors.initials: H
authors.lastname: Dormann
authors.forename: S
authors.initials: S
authors.lastname: Krebs
authors.forename: U
authors.initials: U
authors.lastname: Muth-Selbach
authors.forename: M
authors.initials: M
authors.lastname: Criegee-Rieck
authors.forename: M
authors.initials: M
authors.lastname: Radespiel-Tröger
authors.forename: M
authors.initials: M
authors.lastname: Levy
authors.forename: E G
authors.initials: EG
authors.lastname: Hahn
authors.forename: K
authors.initials: K
authors.lastname: Brune
authors.forename: H T
authors.initials: HT
authors.lastname: Schneider
mesh_terms: D000367:Age Factors; D000368:Aged; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D005767:Gastrointestinal Diseases / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008107:Liver Diseases / Q000188:drug therapy; D008297:Male; D011446:Prospective Studies
chemical_list: D005765:Gastrointestinal Agents