Adverse drug reactions in older Australians, 1981-2002.
OBJECTIVE
To examine trends in adverse drug reactions (ADRs) in people aged 60 years or over causing admission to or an extended stay in Western Australian hospitals between 1981 and 2002.


METHODS
Secondary data analysis of case series.


METHODS
43,380 patients admitted to WA public and private hospitals with an (International Classification of Diseases) ICD external cause code for an ADR, identified by the population-based WA Hospital Morbidity Data System.


METHODS
Age-specific, age-standardised and drug-specific rates of ADR-related hospital stays.


RESULTS
The age-standardised rate of ADR-related hospital stays increased from 2.5 per 1000 person-years (py) in 1981 to 12.9 per 1000 py in 2002. The largest increases occurred in those aged 80 + years (tenfold in men and sevenfold in women). The most common drug group involved was cardiovascular agents (17.5%), while anticoagulants (7.5%), cytotoxics (7.4%) and antirheumatics (6.8%) were the more specific drug classes most often implicated. ADRs from the last three classes of drugs were still rising at the end of the study, whereas ADRs from corticosteroids and antihypertensives peaked in 1996 and from opioids in 2000.


CONCLUSIONS
Increases in hospital admissions or extended lengths of stay due to ADRs in WA have continued despite programs to promote rational and safer use of medicines. The sharp increase in ADRs from anticoagulants warrants attention to revised clinical guidelines.
Burgess
Christel L
CL
School of Population Health, University of Western Australia, Perth, WA 6009, Australia.
Holman
C D'Arcy J
CD
Satti
Anthony G
AG
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D017677:Age Distribution; D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000009:adverse effects; D004358:Drug Therapy / Q000706:statistics & numerical data* / Q000639:trends; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D014904:Western Australia / Q000453:epidemiology
D000305:Adrenal Cortex Hormones; D000700:Analgesics; D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D018501:Antirheumatic Agents; D002317:Cardiovascular Agents