Department of Geriatric Medicine, Vestfold Hospital Trust, Postboks 2168, 3103, Tønsberg, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Eur J Clin Pharmacol. 2019 May;75(5):627-637. doi: 10.1007/s00228-019-02624-1. Epub 2019 Jan 20.
The purpose of the study is to identify and explore risk factors of serious adverse drug events (SADE) and SADE-related admissions in acutely hospitalized multimorbid older adults and assess whether these could have been prevented by adherence to the prescription tools Screening Tool of Older Persons' Prescriptions (STOPP) and The Norwegian General Practice (NORGEP) criteria.
Cross-sectional study of acutely admitted patients to a medical department in a Norwegian regional hospital. Eligible patients were community-dwelling, receiving home care services, and aged 75+, with ≥ 3 chronic diseases. Medications and information regarding the admission were retrieved from the referral letter and medical records, while an expert panel identified SADE using the Common Terminology Criteria for Adverse Events and SADE-related admissions.
We included 232 patients. Mean (SD) age was 86 (5.7) years, 137 (59%) were female, 121 (52%) used 5-9 drugs whereas 65 (28%) used ≥ 10. We identified SADEs in 72 (31%) of the patients, and in 49 (68%) of these cases, the SADE was considered to cause the hospital admission. A low body mass index (BMI) and a high Cumulative Illness Rating Scale-Geriatrics (CIRS-G) score were independent risk factors for SADEs. Among the SADEs identified, 32 (44%) and 11 (15%) were preventable by adherence to STOPP and NORGEP, respectively.
We found a high prevalence of SADE leading to hospitalization. Risk factors for SADE were high CIRS-G and low BMI. STOPP identified more SADEs than NORGEP, but adherence to the prescription tools could only to a limited degree prevent SADEs in this patient group.
本研究旨在确定和探讨急性住院多病老年患者严重药物不良事件（SADE）和与 SADE 相关入院的风险因素，并评估通过遵守处方工具筛选老年人处方（STOPP）和挪威全科实践（NORGEP）标准，这些风险因素是否可以预防。
对挪威一家地区医院内科急性入院患者进行横断面研究。合格患者为居住在社区、接受家庭护理服务、年龄≥75 岁、患有≥3 种慢性疾病的患者。从转诊信和病历中检索药物和入院信息，而一个专家小组则使用常见不良事件术语标准和与 SADE 相关的入院来识别 SADE。
我们纳入了 232 名患者。平均（SD）年龄为 86（5.7）岁，137 名（59%）为女性，121 名（52%）使用 5-9 种药物，而 65 名（28%）使用≥10 种药物。我们在 72 名（31%）患者中发现了 SADE，其中 49 名（68%）患者认为 SADE 导致了入院。低体重指数（BMI）和高累积疾病评分-老年（CIRS-G）评分是 SADE 的独立危险因素。在所确定的 SADE 中，有 32 个（44%）和 11 个（15%）分别可以通过遵守 STOPP 和 NORGEP 来预防。
我们发现导致住院的 SADE 发生率较高。SADE 的危险因素是 CIRS-G 高和 BMI 低。STOPP 比 NORGEP 识别出更多的 SADE，但在该患者群体中，仅通过遵守处方工具，SADE 只能在一定程度上得到预防。
