Portal de Periódicos da CAPES

Adverse Drug Events After Hospital Discharge in Older Adults: Types, Severity, and Involvement of Beers Criteria Medications

2013; Wiley; Volume: 61; Issue: 11 Linguagem: Inglês

10.1111/jgs.12504

1532-5415

Abir O. Kanaan, Jennifer L. Donovan, Nerissa P. Duchin, Terry S. Field, Jennifer Tjia, Sarah L. Cutrona, Shawn J. Gagne, Lawrence Garber, Peggy Preusse, Leslie R. Harrold, Jerry H. Gurwitz,

Pharmacovigilance and Adverse Drug Reactions

Objectives To characterize adverse drug events ( ADE s) occurring within the high‐risk 45‐day period after hospitalization in older adults. Design Clinical pharmacists reviewed the ambulatory records of 1,000 consecutive discharges. Setting A large multispecialty group practice closely aligned with a M assachusetts‐based health plan. Participants Hospitalized individuals aged 65 and older discharged home. Measurements Possible drug‐related incidents occurring during the 45‐day period after hospitalization were identified and presented to a pair of physician‐reviewers who classified incidents as to whether an ADE was present, whether the event was preventable, and the severity of the event. Medications implicated in ADE s were further characterized according to their inclusion in the 2012 B eers C riteria for P otentially I nappropriate M edication U se in O lder A dults. Results At least one ADE was identified during the 45‐day period in 18.7% (n = 187) of the 1,000 discharges. Of the 242 ADE s identified, 35% (n = 84) were deemed preventable, of which 32% (n = 27) were characterized as serious, and 5% (n = 4) as life threatening. More than half of all ADE s occurred within the first 14 days after hospitalization. The percentage of ADE s in which B eers C riteria medications were implicated was 16.5% (n = 40). Beers criteria medications with both a high quality of evidence and strong strength of recommendation were implicated in 6.6% (n = 16) of the ADE s. Conclusion ADE s are common and often preventable in older adults after hospital discharge, underscoring the need to address medication safety during this high‐risk period in this vulnerable population. Beers criteria medications played a small role in these events, suggesting that efforts to improve the quality and safety of medication use during this critical transition period must extend beyond a singular focus on B eers criteria medications.