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

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

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.
Original languageEnglish
Article number105041
JournalJournal of the American Medical Directors Association
Volume25
Issue number7
DOIs
Publication statusPublished - Jul 2024
Externally publishedYes

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