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Adverse Drug Reaction-Related Hospitalizations in Persons Aged 55 Years and Over

A Population-Based Study in the Netherlands

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Abstract

Background: Elderly individuals appear to be particularly at risk of developing adverse drug reactions (ADRs) because of higher rates of polypharmacy, age-related pharmacokinetic changes, pharmacodynamic variations and substantial co-morbidity levels. Thus, the increasing contribution of elderly individuals to the total population means ADR-related hospitalizations are expected to become more frequent. However, a recent study conducted in the Netherlands found that ADR-related hospitalizations had stabilized during the years 1997–2007. Nonetheless, this study did not take into account the number of medicines used.

Objectives: Therefore, the objectives of this study were to describe the association between age and sex, and the risk of an adverse drug reaction (ADR)-related hospitalization in persons aged 55 years and over in the Netherlands and to correlate these ADR-related hospitalizations with the number of dispensed medicines over the same period.

Methods: Data on hospital admissions were obtained from the Dutch nationwide registry of hospital discharges. Data from Statistics Netherlands were used to obtain population demographics. Data on dispensed medicinal products were obtained from the Dutch Foundation for Pharmaceutical Statistics. Analyses were performed by calculating relative risks (RRs).

Results: Those aged ≥75 years were at a more than 4-fold increased risk of being hospitalized in comparison with those aged 55–64 years (RR 4.15; 95% CI 4.12, 4.18). In addition, female sex was associated with an increased risk of an ADR-related hospitalization (RR 1.05; 95% CI 1.03, 1.08) in comparison with males. When taking into account the number of dispensings, elderly ≥75 years of age were at an increased risk of being hospitalized for an ADR due to anticoagulants (RR 2.20; 95% CI 2.12, 2.28), antidiabetic agents (RR 3.53; 95% CI 3.39, 3.66), salicylates (RR 1.70; 95% 1.54, 1.86) and antirheumatics (RR 2.19; 95% CI 2.06, 2.33).

Conclusion: In our study, we showed that elderly aged ≥75 years were at increased risk of an ADR-related hospitalization. Given that the number of elderly and very old will continue to grow, it is of pivotal importance to further endorse drug safety in this vulnerable patient group.

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Acknowledgements

No sources of funding were used to conduct this study and assist in the preparation of this article. The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Epidemiology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands

    Rikje Ruiter, Loes E. Visser, Eline M. Rodenburg, Gijsbertus Ziere & Bruno H. Stricker PhD.

  2. Drug Safety Unit, Inspectorate of Health Care, The Hague, the Netherlands

    Rikje Ruiter, Eline M. Rodenburg & Bruno H. Stricker PhD.

  3. Department of Hospital Pharmacy, Erasmus MC, Rotterdam, the Netherlands

    Loes E. Visser

  4. Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands

    Loes E. Visser, Gijsbertus Ziere & Bruno H. Stricker PhD.

  5. Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands

    Gianluca Trifiró & Bruno H. Stricker PhD.

  6. Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Messina, Italy

    Gianluca Trifiró

Authors
  1. Rikje Ruiter
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  2. Loes E. Visser
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  3. Eline M. Rodenburg
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  4. Gianluca Trifiró
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  5. Gijsbertus Ziere
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  6. Bruno H. Stricker PhD.
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Correspondence to Bruno H. Stricker PhD..

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Ruiter, R., Visser, L.E., Rodenburg, E.M. et al. Adverse Drug Reaction-Related Hospitalizations in Persons Aged 55 Years and Over. Drugs Aging 29, 225–232 (2012). https://doi.org/10.2165/11599430-000000000-00000

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