dc.contributor.author	Jennings, Emma L. M.
dc.contributor.author	Murphy, Kevin D.
dc.contributor.author	Gallagher, Paul
dc.contributor.author	O'Mahony, Denis
dc.contributor.funder	Horizon 2020	en
dc.date.accessioned	2020-10-21T16:19:43Z
dc.date.available	2020-10-21T16:19:43Z
dc.date.issued	2020-10-06
dc.date.updated	2020-10-15T08:00:24Z
dc.description.abstract	Background: the prevalence of adverse drug reactions (ADRs) in hospitalised older patients, their clinical presentations, causative drugs, severity, preventability and measurable outcomes are unclear, ADRs being an increasing challenge to older patient safety. Methods: we systematically searched PubMed, Embase, EBSCO-CINAHL, the Cochrane Library, ‘rey’ literature and relevant systematic review bibliographies, published from database inception to March 2020. We included any study reporting occurrence of in-hospital ADRs as primary or secondary outcomes in hospitalised older adults (mean age ≥ 65 years). Two authors independently extracted relevant information and appraised studies for bias. Study characteristics, ADR clinical presentations, causative drugs, severity, preventability and clinical outcomes were analysed. Study estimates were pooled using random-effects meta-analytic models. Results: from 2,399 abstracts, we undertook full-text screening in 286, identifying 27 studies (29 papers). Final analysis yielded a pooled ADR prevalence of 16% (95%CI 12–22%, I2 98%,τ2 0.8585), in a population of 20,153 hospitalised patients aged ≥65 years of whom 2,479 patients experienced ≥ one ADR. ADR ascertainment was highly heterogeneous. Almost 48.3% of all ADRs involved five presentations: fluid/electrolyte disturbances (17.3%), gastrointestinal motility/defaecation disorders (13.3%), renal disorders (8.2%), hypotension/blood pressure dysregulation disorders/shock (5.5%) and delirium (4.1%). Four drug classes accounted for 57.8% of causative medications i.e. diuretics (19.8%), anti-bacterials (14.8%), antithrombotic agents (12.2%) and analgesics (10.9%). Pooled analysis of severity was not feasible. Four studies reported the majority of ADRs as preventable (55–95%). Conclusions: on average, 16% of hospitalised older patients experience significant ADRs, varying in severity and mostly preventable, with commonly prescribed drug classes accounting for most ADRs.	en
dc.description.status	Peer reviewed	en
dc.description.version	Accepted Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.articleid	11	en
dc.identifier.citation	Jennings, E. L. M., Murphy, K. D., Gallagher, P. and O’Mahony, D. (2020) 'In-hospital adverse drug reactions in older adults; prevalence, presentation and associated drugs—a systematic review and meta-analysis', Age and Ageing, afaa188, (11 pp). doi: 10.1093/ageing/afaa188	en
dc.identifier.doi	10.1093/ageing/afaa188	en
dc.identifier.endpage	1	en
dc.identifier.issn	0002-0729
dc.identifier.journaltitle	Age and Ageing	en
dc.identifier.uri	https://hdl.handle.net/10468/10678
dc.language.iso	en	en
dc.publisher	Oxford University Press	en
dc.relation.project	info:eu-repo/grantAgreement/EC/H2020::RIA/634238/EU/OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly/OPERAM	en
dc.rights	© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. This is the submitted pre-copyedited, author-produced PDF of an article accepted for publication in Age and Ageing. The version of record is available online at https://doi.org/10.1093/ageing/afaa188	en
dc.subject	Older people	en
dc.subject	Adverse drug reaction	en
dc.subject	Polypharmacy	en
dc.subject	Multi-morbidity	en
dc.subject	Inpatient	en
dc.subject	Iatrogenic	en
dc.title	In-hospital adverse drug reactions in older adults; prevalence, presentation and associated drugs—a systematic review and meta-analysis	en
dc.type	Article (peer-reviewed)	en

In-hospital adverse drug reactions in older adults; prevalence, presentation and associated drugs—a systematic review and meta-analysis

Files

Original bundle

License bundle

Collections