A study of adverse drug reactions in hospitalized patients in relation to age

• Autores: María Ganeva, Tanya Gancheva, Jeni Troeva, Desislava Gancheva, Evgenya Hristakieva
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 18, Nº. 3, 2016, págs. 154-162
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Background. Older age is generally accepted as a risk factor for Adverse Drug Reactions (ADR). Cutaneous reactions to drugs are a common challenge in everyday medical practice because of their non-specific and variable clinical presentation. The association of age with drug allergy is still less well studied.

    Objective. The aim of the study was to evaluate and compare the characteristics of ADR in different age groups of patients hospitalized for the treatment of dermatological disorders.

    Method. A prospective non-interventional pharmacovigilance study was conducted among patients consecutively hospitalized in the Clinic of Dermatology and Venereology, University Hospital in Stara Zagora, Bulgaria from March 2013 to March 2015. ADR were classified by clinical manifestation, type, causality (according to Naranjo et al., 1981), severity (according to Hartwig et al., 1992) and preventability (according to Hallas et al., 1990). Patients were divided in two age groups: below 65 years and above 65 years.

    Results. For the study period 61 ADR in 58 patients manifesting as skin, metabolic, cardiovascular, vision and other types of disorders were detected. Cutaneous ADR accounted for 60.7% of all ADR. The distribution of ADR according to type yielded 20 (32.8%) «type A» reactions, 34 (55.7%) «type B» reactions, 5 (8.2%) «type C» reactions and 2 (3.3%) «type E» ADR. Regarding causality 37 ADR (60.7%) were scored as «possible» and 24 (39.3%) as «probable». Severity assessment showed that ADR leading to hospital admission classified as «level 4B» reactions (37 or 60.7% of all ADR) were prevalent. Evaluation of ADR preventability revealed that 40 (65.6%) of the reactions were «unavoidable», 15 (24.6%) «possibly avoidable», 5 (8.2%) «definitely avoidable» and 1 (1.6%) «unclassifiable». The study did not identify any signi􀂿cant differences in younger and older patients concerning ADR type, causality and preventability. There was a tendency for some prevalence of «type B» ADR in patients below 65 years of age and significantly more ADR leading to hospitalization (p = 0.03) in this age group.

    Conclusions. The prevalence of ADR hospital admissions in younger patients in this study is associated with the clinical setting and the detection of more «type B» ADR in dermatology patients. Other patient-related factors like reduced cognitive capacity and communication in the elderly may also play a contributing role