Adverse Drug Event-Related Hospital Admissions among Australian Aged Care Residents: A Cross-Sectional Study

Sheraz Ali; Gregory M Peterson; Colin M Curtain; Andrea Wilson; Mohammed S Salahudeen

doi:10.1016/j.jamda.2024.105041

Adverse Drug Event-Related Hospital Admissions among Australian Aged Care Residents: A Cross-Sectional Study

J Am Med Dir Assoc. 2024 May 22;25(7):105041. doi: 10.1016/j.jamda.2024.105041. Online ahead of print.

Authors

Sheraz Ali¹, Gregory M Peterson², Colin M Curtain², Andrea Wilson³, Mohammed S Salahudeen²

Affiliations

¹ School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia. Electronic address: sheraz.ali@utas.edu.au.
² School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
³ Department of Geriatric Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.

PMID: 38796163
DOI: 10.1016/j.jamda.2024.105041

Abstract

Objectives: To investigate the proportion, characteristics, causality, severity, preventability, and independently associated factors for adverse drug event (ADE)-related admissions in aged care residents admitted to the major public hospitals in Tasmania, Australia.

Design: Retrospective cross-sectional study.

Setting and participants: Residential aged care facility (RACF) patients aged ≥65 years who had an unplanned admission to one of the 4 Tasmanian public hospitals between July 1, 2018, and June 30, 2021.

Methods: We accessed the medical records of RACF patients. The ADEs were initially identified via chart review and a trigger tool. Hospitalizations attributable to ADEs were then determined by expert consensus. The causality, preventability, and severity of each ADE admission were assessed using standard criteria.

Results: Ninety-one residents (18.2%) of 500 randomly selected experienced potential ADE-related hospitalizations. ADEs were considered possible (n = 58, 64%) or definite/probable (n = 33, 36%). The most common ADEs were falls (n = 19, 21%), hypotension (n = 16, 18%), and confusion or delirium (n = 10, 11%). ADEs were frequently associated with renin-angiotensin system inhibitors (n = 43, 47.3%), opioids (n = 43, 47.3%), and diuretics (n = 40, 44%). Most ADEs were of moderate severity (n = 90, 99%) and considered not preventable (n = 60, 66%). Rheumatologic disease [odds ratio (OR) 1.89, 95% CI 1.09-3.30; P = .024] and previous adverse drug reaction (ADR) (OR 12.91, 95% CI 6.84-24.37; P < .001) were associated with ADE hospitalizations.

Conclusions and implications: This study highlights that hospitalization for moderately severe ADEs is common among RACF residents. Opioids and antihypertensives were the common drug classes associated with harm. Rheumatologic disease (due to opioids) and previous ADR were identified as independently associated factors, which may warrant tailored interventions.

Keywords: Adverse drug event; aged care; elderly; fall; hospital admission; injury; medicines-related harm.