Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia.
Healthy Care Services, Adelaide, Australia.
Drug Saf. 2023 May;46(5):493-500. doi: 10.1007/s40264-023-01299-z. Epub 2023 Apr 19.
Aged care residents are vulnerable to the harmful effects of medicines; however, data on the prevalence and preventability of adverse medicine events in aged care residents are scarce.
To determine the prevalence and preventability of adverse medicine events in Australian aged care residents.
A secondary analysis of data from the Reducing Medicine-Induced Deterioration and Adverse Reactions (ReMInDAR) trial was conducted. Potential adverse medicine events were identified and independently screened by two research pharmacists to produce a short-list of potential adverse medicine events. An expert clinical panel reviewed each potential adverse medicine to determine the likelihood that the event was medicine related (based on the Naranjo Probability Scale criteria). The clinical panel assessed preventability of medicine-related events using Schumock-Thornton criteria.
There were 583 adverse events due to medicines, involving 154 residents (62% of the 248 study participants). There was a median of three medication-related adverse events (interquartile range [IQR] 1-5) per resident over the 12-month follow-up period. The most common medication-related adverse events were falls (56%), bleeding (18%) and bruising (9%). There were 482 (83%) medication-related adverse events that were preventable, most commonly falls (66% of preventable adverse medicine events), bleeding (12%) and dizziness (8%). Of the 248 residents, 133 (54% of the cohort) had at least one preventable adverse medicine event, with a median of 2 (IQR 1-4) preventable adverse medicine events per resident.
In total, 62% of aged care residents in our study had an adverse medicine event and 54% had a preventable adverse medicine event in a 12-month period.
老年护理居民易受药物不良影响;然而,关于老年护理居民不良药物事件的发生率和可预防性的数据却很少。
确定澳大利亚老年护理居民不良药物事件的发生率和可预防性。
对减少药物引起的恶化和不良反应(ReMInDAR)试验的数据进行二次分析。由两名研究药剂师独立识别和筛选潜在的不良药物事件,以产生潜在不良药物事件的简短列表。一个专家临床小组审查每个潜在的不良药物事件,以确定该事件是否与药物相关的可能性(基于 Naranjo 概率量表标准)。临床小组使用 Schumock-Thornton 标准评估与药物相关的事件的可预防性。
共有 583 例药物相关不良事件,涉及 154 名居民(248 名研究参与者中的 62%)。在 12 个月的随访期间,每位居民平均发生 3 次与药物相关的不良事件(中位数[IQR] 1-5)。最常见的与药物相关的不良事件是跌倒(56%)、出血(18%)和瘀伤(9%)。有 482 例(83%)药物相关不良事件是可预防的,最常见的是跌倒(66%的可预防药物不良事件)、出血(12%)和头晕(8%)。在 248 名居民中,有 133 名(队列的 54%)至少有一次可预防的药物不良事件,每位居民的中位数为 2 次(IQR 1-4)可预防的药物不良事件。
在我们的研究中,共有 62%的老年护理居民在 12 个月内发生了药物不良事件,54%的居民发生了可预防的药物不良事件。