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Polypharmacy, adverse drug-related events, and potential adverse drug interactions in elderly patients presenting to an emergency department
Abstract
Study objectives We sought to document the degree of polypharmacy, the frequency of adverse drug-related events (ADREs) leading to emergency department presentation that were recognized by emergency physicians, and the frequency of potential adverse drug interactions (PADIs) in medication regimens of elderly patients in the ED.Methods We conducted a retrospective chart review on 300 randomly selected ED visits made by patients 65 years of age and older between January 1 and December 31, 1998. ADREs were defined according to a standardized algorithm. PADIs were identified by using the drug interaction database PharmVigilance.Results After excluding 17 patient visits with inadequate documentation, 283 were left for review. Of these, 257 (90.8%) patients were taking 1 or more medications (prescribed or over the counter). The number of medications consumed ranged from 0 to 17 and averaged 4.2 (SD+/-3.1) drugs per patient. ADREs accounted for 10.6% of all ED visits in our patient group. The most frequently implicated classes of medications were nonsteroidal anti-inflammatory drugs, antibiotics, anticoagulants, diuretics, hypoglycemics, beta-blockers, calcium-channel blockers, and chemotherapeutic agents. Thirty-one percent of all patients in our group had at least 1 PADI in their medication list. Among patients who presented because of an ADRE, 50% had at least 1 PADI in their medication list that was unrelated to the ADRE with which they presented.Conclusion ADREs are an important cause of ED presentation in the elderly. PADIs are found in a significant proportion of medication lists. Emergency physicians must be vigilant in monitoring elderly patients for medication-related problems.
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“the importance of medication counts in the model may either reflect a proxy feature for medical complexity or indicate that polypharmacy itself is a risk factor [42,43].”
From Predicting hospital admission at emergency department triage using machine learning (2018) · cites this paper as [42]
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Metadata
- Authors
- Hohl, C. M., Dankoff, J., Colacone, A., & Afilalo, M.
- Affiliations
- Jewish General Hospital (CA)
- Venue
- Annals of Emergency Medicine
- Publisher
- Elsevier BV
- Published
- 2001-12
- Volume
- 38
- Issue
- 6
- Pages
- 666-671
- ISSN
- 0196-0644 (ISSN-L)
- OpenAlex
- W2034981842
- Cited by
- 477
- References
- 22
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 20 · 2023: 14 · 2022: 20 · 2021: 15 · 2020: 16 · 2019: 22 · 2018: 33 · 2017: 24 · 2016: 21 · 2015: 28 · 2014: 25 · 2013: 29 · 2012: 24
- FWCI
- 4.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Emergency Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- polypharmacy, adverse drug interactions, elderly patients, emergency department visits, drug-related problems, drug safety, nonsteroidal anti-inflammatory drugs, anticoagulants, antibiotics, over-the-counter drugs
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Drug Interactions, Drug Therapy, Combination, Emergency Service, Hospital, Female, Hospitals, General, Humans, Male, Quebec, Retrospective Studies
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