Predictors of Adverse Drug Reaction-Related Hospitalisations Among People with Dementia: A Retrospective Case-Control Study.

IF 4 2区医学 Q1 PHARMACOLOGY & PHARMACY Drug Safety Pub Date : 2024-08-01 Epub Date: 2024-05-13 DOI:10.1007/s40264-024-01435-3

Anum Saqib Zaidi, Gregory M Peterson, Colin M Curtain, Mohammed S Salahudeen

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Abstract

Introduction: Adverse drug reactions (ADRs) are common among people with dementia; however, little is known about the magnitude and predictors associated with ADR-related hospitalisation among these individuals. This study aimed to determine the magnitude, types, drugs implicated and predictors of ADRs associated with hospitalisation among people with dementia.

Methods: This retrospective case-control study analysed medical records of individuals aged ≥ 65 years with dementia admitted to major public hospitals in Tasmania, Australia, from July 2010 to July 2021. Adverse drug reactions and implicated drugs were identified using administrative data and cross-checked with hospital medical records, with consensus reached among the research team.

Results: Of the 7928 people admitted to hospital at least once within the study period, 1876 (23.7%) experienced at least one ADR-related hospitalisation. Of these, 300 case patients with 311 ADRs and 300 control patients were randomly selected. The most common types of ADRs were renal (acute kidney injury; AKI) (36.0%), followed by neuropsychiatric (17.6%), cardiovascular (16.0%) and haematological (13.1%). Diuretics, renin-angiotensin system (RAS) inhibitors and anti-thrombotics constituted the main implicated drug classes. The ADR-related hospitalisation was associated with: chronic kidney disease (CKD) (OR 8.00, 95% CI 2.63-24.28, p < 0.001), Australian-born (OR 1.62, 95% CI 1.08-2.43, p = 0.019), hypertension (OR 1.48, 95% CI 1.01-2.17, p = 0.044) and the number of medicines (OR 1.06, 95% CI 1.00-1.12, p = 0.022). Potentially inappropriate medication use and anticholinergic burden did not predict ADR-related hospitalisation.

Conclusions: These predictors could help identify the individuals at the highest risk and enable targeted interventions to be designed.

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痴呆症患者因药物不良反应住院的预测因素：一项回顾性病例对照研究。

简介：药物不良反应（ADRs）在痴呆症患者中很常见；然而，人们对这些患者中与 ADR 相关的住院治疗的规模和预测因素却知之甚少。本研究旨在确定与痴呆症患者住院相关的药物不良反应的程度、类型、涉及的药物和预测因素：这项回顾性病例对照研究分析了 2010 年 7 月至 2021 年 7 月期间澳大利亚塔斯马尼亚州各大公立医院收治的年龄≥ 65 岁的痴呆症患者的医疗记录。研究人员利用行政数据确定了药物不良反应和相关药物，并与医院医疗记录进行了交叉核对，最终在研究小组之间达成了共识：在研究期间至少入院一次的 7928 人中，有 1876 人（23.7%）至少经历过一次与 ADR 相关的住院治疗。在这些患者中，随机抽取了 300 名有 311 例 ADR 的病例患者和 300 名对照组患者。最常见的 ADR 类型是肾脏（急性肾损伤；AKI）（36.0%），其次是神经精神（17.6%）、心血管（16.0%）和血液（13.1%）。利尿剂、肾素-血管紧张素系统（RAS）抑制剂和抗血栓药物是主要的相关药物类别。与 ADR 相关的住院治疗与以下因素有关：慢性肾病（CKD）（OR 8.00，95% CI 2.63-24.28，p < 0.001）、澳大利亚出生（OR 1.62，95% CI 1.08-2.43，p = 0.019）、高血压（OR 1.48，95% CI 1.01-2.17，p = 0.044）和药物数量（OR 1.06，95% CI 1.00-1.12，p = 0.022）。潜在的用药不当和抗胆碱能药物负担并不能预测与ADR相关的住院治疗：这些预测指标有助于识别风险最高的人群，从而设计出有针对性的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Safety 医学-毒理学

CiteScore

7.60

自引率

7.10%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.