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. 2013 Nov;61(11):1894-9.
doi: 10.1111/jgs.12504. Epub 2013 Oct 1.

Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications

Abir O Kanaan  1 , 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
Affiliations

Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications

Abir O Kanaan et al. J Am Geriatr Soc. 2013 Nov.

Abstract

Objectives: To characterize adverse drug events (ADEs) 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 Massachusetts-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 ADEs were further characterized according to their inclusion in the 2012 Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.

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 ADEs 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 ADEs occurred within the first 14 days after hospitalization. The percentage of ADEs in which Beers Criteria 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 ADEs.

Conclusion: ADEs 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 Beers criteria medications.

Keywords: Beers medications; adverse drug events; ambulatory care setting; older adults.

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Conflict of interest statement

Conflict of interest

Nerissa Duchin was supported by a Medical Student Training in Aging Research Award (MSTAR) from the American Federation for Aging Research (AFAR).

The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

Figures

Figure 1
Figure 1
Number of days post discharge to first event
See this image and copyright information in PMC

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References

    1. Beers MH, Sliwkowski J, Brooks J. Compliance with medication orders among the elderly after hospital discharge. Hosp Formul. 1992;27:720–724. - PubMed
    1. Forster AJ, Clark HD, Menard A, et al. Adverse events among medical patients after discharge from hospital. CMAJ. 2004;170:345–349. - PMC - PubMed
    1. Forster AJ, Murff HJ, Peterson JF, et al. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003;138:161–167. - PubMed
    1. Beers MH, Dang J, Hasegawa J, et al. Influence of hospitalization on drug therapy in the elderly. J Am Geriatr Soc. 1989;37:679–683. - PubMed
    1. Calkins DR, Davis RB, Reiley P, et al. Patient-physician communication at hospital discharge and patients’ understanding of the postdischarge treatment plan. Arch Intern Med. 1997;157:1026–1030. - PubMed

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