title: Hospitalization in older patients due to adverse drug reactions -the need for a prediction tool.
abstract: Adverse drug reactions (ADRs) represent a major burden on society, resulting in significant morbidity, mortality, and health care costs. Older patients living in the community are particularly susceptible to ADRs, and are at an increased risk of ADR-related hospitalization. This review summarizes the available evidence on ADR-related hospital admission in older patients living in the community, with a particular focus on risk factors for ADRs leading to hospital admission and the need for a prediction tool for risk of ADR-related hospitalization in these individuals. The reported proportion of hospital admissions due to ADRs has ranged from 6% to 12% of all admissions in older patients. The main risk factors or predictors for ADR-related admissions were advanced age, polypharmacy, comorbidity, and potentially inappropriate medications. There is a clear need to design intervention strategies to prevent ADR-related hospitalization in older patients. To ensure the cost-effectiveness of such strategies, it would be necessary to target them to those older individuals who are at highest risk of ADR-related hospitalization. Currently, there are no validated tools to assess the risk of ADRs in primary care. There is a clear need to investigate the utility of tools to identify high-risk patients to target appropriate interventions toward prevention of ADR-related hospital admissions.
authors.affiliation: Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Hobart, TAS, Australia.
authors.forename: Nibu
authors.initials: N
authors.lastname: Parameswaran Nair
authors.affiliation: Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Hobart, TAS, Australia.
authors.forename: Leanne
authors.initials: L
authors.lastname: Chalmers
authors.affiliation: Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Hobart, TAS, Australia.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Peterson
authors.affiliation: Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Hobart, TAS, Australia.
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Bereznicki
authors.affiliation: Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Hobart, TAS, Australia.
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Castelino
authors.affiliation: Division of Pharmacy, School of Medicine, Faculty of Health, University of Tasmania, Hobart, TAS, Australia.
authors.forename: Luke R
authors.initials: LR
authors.lastname: Bereznicki
mesh_terms: D000368:Aged; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D019338:Polypharmacy; D011320:Primary Health Care; D012307:Risk Factors
keywords: adverse drug reactions; hospital admission; older patients; prediction; primary care; risk factors