title: Safety assessment of potentially inappropriate medications use in older people and the factors associated with hospital admission.
abstract: OBJECTIVE
  Potentially Inappropriate Medications (PIM) use in elderly people may be responsible for the development of Adverse Drug Reaction (ADR) which, when severe, leads to hospital admissions.
  
  
  OBJECTIVE
  to estimate the prevalence of elderly who had used PIM before being admitted to hospital admission and to identify the risk factors and the hospitalizations related to ADR arising from PIM.
  
  
  METHODS
  A descriptive and cross-sectional study was performed in the internal medicine ward of a teaching hospital (Brazil), in 2008. With the aid of a validated form, patients aged ≥ 60 years, with length of hospital stay ≥ 24 hours, were interviewed about drugs taken prior to the hospital admission and the complaints/reasons for hospitalization.
  
  
  RESULTS
  19.1% (59/308) of older patients had taken PIM before hospital admission and in 4.9%; there were a causal relation between the PIM taken and the complaint reported. PIM responsible for admissions were: amiodarone, amitriptyline, cimetidine, clonidine, diazepam, digoxin, estrogen, fluoxetine, lorazepam, short-acting nifedipine and propranolol. 47.0% of the clinical manifestations of PIM-related ADR were: dizziness, fatigue, digoxin toxicity and erythema. Only polypharmacy was detected as a risk factor for the occurrence of ADR of PIM (p = 0.02).
  
  
  CONCLUSIONS
  PIM use in elderly people is not a risk factor for ADR-related hospital admission. Probably, severe ADR, which lead to hospitalizations of older people, can be explained by idiosyncratic response or the predisposition of these patients to develop adverse drug events, whether or not drugs are classed as PIM.
authors: School of Pharmaceutical Sciences of the Universidade Estadual Paulista Júlio de Mesquita Filho, Araraquara (SP), Brazil.
authors: Fabiana Rossi
authors: FR
authors: Varallo
authors: Helaine Carneiro
authors: HC
authors: Capucho
authors: Cleópatra Silva
authors: CS
authors: Planeta
authors: Patrícia de Carvalho
authors: Pde C
authors: Mastroianni
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D057970:Inappropriate Prescribing / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D012307:Risk Factors