title: Development and validation of a risk model for predicting adverse drug reactions in older people during hospital stay: Brighton Adverse Drug Reactions Risk (BADRI) model.
abstract: BACKGROUND
  Older patients are at an increased risk of developing adverse drug reactions (ADR). Of particular concern are the oldest old, which constitute an increasingly growing population. Having a validated clinical tool to identify those older patients at risk of developing an ADR during hospital stay would enable healthcare staff to put measures in place to reduce the risk of such an event developing. The current study aimed to (1) develop and (2) validate an ADR risk prediction model.
  
  
  METHODS
  We used a combination of univariate analysis and multivariate binary logistic regression to identify clinical risk factors for developing an ADR in a population of older people from a UK teaching hospital. The final ADR risk model was then validated in a European population (European dataset).
  
  
  RESULTS
  Six-hundred-ninety patients (median age 85 years) were enrolled in the development stage of the study. Ninety-five reports of ADR were confirmed by independent review in these patients. Five clinical variables were identified through multivariate analysis and included in our final model; each variable was attributed a score of 1. Internal validation produced an AUROC of 0.74, a sensitivity of 80%, and specificity of 55%. During the external validation stage the AUROC was 0.73, with sensitivity and specificity values of 84% and 43% respectively.
  
  
  CONCLUSIONS
  We have developed and successfully validated a simple model to use ADR risk score in a population of patients with a median age of 85, i.e. the oldest old. The model is based on 5 clinical variables (≥8 drugs, hyperlipidaemia, raised white cell count, use of anti-diabetic agents, length of stay ≥12 days), some of which have not been previously reported.
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains, Malaysia, Pulau Pinang, Malaysia.
authors.forename: Balamurugan
authors.initials: B
authors.lastname: Tangiisuran
authors.affiliation: Institute of Pharmaceutical Science, King's College London, London, United Kingdom.
authors.forename: Greg
authors.initials: G
authors.lastname: Scutt
authors.affiliation: Institute of Pharmaceutical Science, King's College London, London, United Kingdom.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Stevenson
authors.affiliation: Department of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom.
authors.forename: Juliet
authors.initials: J
authors.lastname: Wright
authors.affiliation: Department of Geriatrics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Onder
authors.affiliation: Department of Geriatrics and Gerontology, Ghent University Hospital, Ghent, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Petrovic
authors.affiliation: Department of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom; Department of Internal Medicine, Section of Geriatric Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands.
authors.forename: T J
authors.initials: TJ
authors.lastname: van der Cammen
authors.affiliation: Department of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom.
authors.forename: Chakravarthi
authors.initials: C
authors.lastname: Rajkumar
authors.affiliation: Institute of Pharmaceutical Science, King's College London, London, United Kingdom.
authors.forename: Graham
authors.initials: G
authors.lastname: Davies
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D019992:Databases as Topic; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis*; D005060:Europe; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D015999:Multivariate Analysis; D015203:Reproducibility of Results; D012307:Risk Factors