title: Increased risk of hospital admission for dehydration or heat-related illness after initiation of medicines: a sequence symmetry analysis.
abstract: OBJECTIVE
  Although several studies have identified factors which increase the risk of heat-related illness, few have assessed the contribution of medicines. To address this knowledge gap, our study aimed to assess the risk of hospital admission for dehydration or other heat-related illness following initiation of medicines.
  
  
  METHODS
  We conducted a retrospective analysis using prescription event symmetry analysis (PESA) of 6700 veterans with incident hospital admission for dehydration or heat-related illness (ICD-10-AM codes E86, X30, T67), between 1 January 2001 and 30 June 2013. The main outcome measure was first ever hospital admission for dehydration or heat-related illness following initiation of commonly used medicines.
  
  
  CONCLUSIONS
  A significantly higher risk of incident hospital admission for dehydration or heat-related illness was observed following initiation of anticoagulants, cardiovascular medicines, NSAIDs, antipsychotics, antidepressants and anticholinergic agents. The risk of hospital admission for dehydration or heat-related illness ranged from 1·17 (SSRIs) to 2·79 (ACEI plus diuretic combination product). No significant association was observed between initiation of anticonvulsants, anti-Parkinson's agents, hypnotics, anxiolytics or antihistamines and hospital admission for dehydration or heat-related illness.
  
  
  CONCLUSIONS
  Many commonly used medicines were found to be associated with increased risk of hospitalization for dehydration or heat-related illness. Initiation of ACE inhibitors in combination with diuretics had the highest risk. Prescribers and patients should be aware of the potential for medicines to be associated with increased risk of dehydration and heat-related illness.
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: L M
authors.initials: LM
authors.lastname: Kalisch Ellett
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: N L
authors.initials: NL
authors.lastname: Pratt
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: V T
authors.initials: VT
authors.lastname: Le Blanc
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Westaway
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: E E
authors.initials: EE
authors.lastname: Roughead
mesh_terms: D000369:Aged, 80 and over; D003681:Dehydration / Q000139:chemically induced*; D005260:Female; D006760:Hospitalization; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008297:Male; D055553:Prescription Drugs / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D055553:Prescription Drugs
keywords: adverse drug reaction; dehydration; pharmacoepidemiology; thermoregulation