An observational Study to analyze the Adverse drug Reactions among the Elderly at A Tertiary Care Hospital
C. R. Jayanthi, M. Renuka, and P. PanchaksharimathDepartment, of pharmacology, Bangalore medical college and research institute, Bengaluru, India.
Abstract: Adverse drug reactions [ADRs] are more frequently encountered in the elderly (> 60 years) population. The etiology is multifactorial and often interconnected with interplay of many factors like polypharmacy, altered drug pharmacokinetic and pharmacodynamics responses, drug interactions that increase their risk for ADR, making them a vulnerable population. Hence, the present study was taken up.To evaluate clinical pattern, causality, severity and preventability of ADR’s in the elderly population. To evaluate Potentially inappropriate medicines [PIM] leading to ADRs using Beer’s criteria. An observational study was conducted from 2011 to 2015 to analyze ADRs in elderly reported from Victoria hospital attached to BMC&RI. Relevant data on patient’s demographics, details of ADR’s, causal drug details, outcome were collected as per CDSCO ADR reporting form. Causality was assessed using WHO causality assessment scale, severity using modified Hartwig and Siegel severity scale and preventability by modified Thornton and Schumock scale. Potentially inappropriate medicines (PIM) were determined according to Beer’s criteria. A total of 89 ADRs were reported during the study period, out of which 11% were reported in elderly. Majority (86%) were noted in the age group of 60-70 years. Dermatological (34%) followed by GIT (24%) system was predominantly affected due to ADR’s. Maculopapular rash (29.21%) was the most common ADR followed by gastritis (7.86%) and diarrhea (5.61%). Major contribution to the ADR’s was from J01cephalosporins (22.5%), N02 NSAID’s (20.22%) and J05 antiviral (6.7%) of the ATC groups. 87.6% of the ADR’s were probable and 12.4% were possible on WHO causality scale. Most ADRs were mild (51.68%) and moderate (44.94%). Majority were type A (98.87%) ADRs and probably preventable (92.1%). According to Beer’s criteria 30.33% of drugs causing ADR were PIM with NSAID’s (20.22%) being the most common inappropriately prescribed drugs. Most of the ADRs in elderly are predictable and preventable and are caused by commonly prescribed drugs like antibacterial and analgesics. Nearly one fourth of the ADRs were due to PIM which can be minimized by careful application of Beer’s criteria.
Keywords: adverse drug reactions; elderly; causality; Beer’s criteria; Thornton and Schumock; Hartwig scale Back to TOC