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Polypharmacy as a risk factor for adverse drug reactions in geriatric nursing home residents.
Am J Geriatr Pharmacother. 2006 Mar; 4(1):36-41.AJ

Abstract

OBJECTIVE

Polypharmacy is a well-known risk factor for adverse drug reactions (ADRs). The objective of this study was to determine the relationship between the use of > or = 9 different scheduled medications and the occurrence of ADRs in geriatric nursing home residents.

METHODS

This was a retrospective cohort study conducted in a 1200-bed, county-owned and -operated, longterm care skilled nursing facility Participants were 335 subjects aged > or = 65 years who were present at the facility during the index month of October 1998. Hospice, respite care, and rehabilitation patients were excluded. Use of > or = 9 different scheduled medications was defined a priori as routinely administered medications, excluding as-needed agents, topical agents, 1-time administration, and vaccinations. ADRs were identified by voluntary reporting and by chart review during a 12-month period. ADRs were assessed individually by 2 clinical pharmacists applying the Naranjo ADR probability scale.

RESULTS

A total of 207 ADRs were identified. The cohort receiving > or = 9 scheduled medications (n = 43) experienced 53 ADRs, compared with 154 ADRs in the control group receiving <9 medications (n = 292). The demographic distribution was similar in both cohorts, with white as the dominant ethnicity; 45% were white in the control group and 51% were white in the cohort group receiving > or = 9 scheduled medications. The sex distribution was also similar, with women outnumbering men in both cohorts: 60% and 81% were women in the control and cohort groups, respectively. The mean age was 72 years (range, 65-100 years). After the data were adjusted for the number of days each subject was at risk for experiencing an ADR, subjects using > or = 9 different scheduled medications were 2.33 times more likely than controls to experience an ADR (95% CI, 1.54-3.52; P < 0.001).

CONCLUSION

A positive correlation between the use of >/=9 different scheduled medications and ADRs was found among these geriatric nursing home residents.

Authors+Show Affiliations

Kaiser Permanente Woodland Hills Medical Center, Woodland Hills, California 91367, USA. Julia.K.Nguyen@kp.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16730619

Citation

Nguyen, Julia K., et al. "Polypharmacy as a Risk Factor for Adverse Drug Reactions in Geriatric Nursing Home Residents." The American Journal of Geriatric Pharmacotherapy, vol. 4, no. 1, 2006, pp. 36-41.
Nguyen JK, Fouts MM, Kotabe SE, et al. Polypharmacy as a risk factor for adverse drug reactions in geriatric nursing home residents. Am J Geriatr Pharmacother. 2006;4(1):36-41.
Nguyen, J. K., Fouts, M. M., Kotabe, S. E., & Lo, E. (2006). Polypharmacy as a risk factor for adverse drug reactions in geriatric nursing home residents. The American Journal of Geriatric Pharmacotherapy, 4(1), 36-41.
Nguyen JK, et al. Polypharmacy as a Risk Factor for Adverse Drug Reactions in Geriatric Nursing Home Residents. Am J Geriatr Pharmacother. 2006;4(1):36-41. PubMed PMID: 16730619.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polypharmacy as a risk factor for adverse drug reactions in geriatric nursing home residents. AU - Nguyen,Julia K, AU - Fouts,Michelle M, AU - Kotabe,Sharon E, AU - Lo,Eunice, PY - 2006/01/29/received PY - 2006/5/30/pubmed PY - 2006/6/23/medline PY - 2006/5/30/entrez SP - 36 EP - 41 JF - The American journal of geriatric pharmacotherapy JO - Am J Geriatr Pharmacother VL - 4 IS - 1 N2 - OBJECTIVE: Polypharmacy is a well-known risk factor for adverse drug reactions (ADRs). The objective of this study was to determine the relationship between the use of > or = 9 different scheduled medications and the occurrence of ADRs in geriatric nursing home residents. METHODS: This was a retrospective cohort study conducted in a 1200-bed, county-owned and -operated, longterm care skilled nursing facility Participants were 335 subjects aged > or = 65 years who were present at the facility during the index month of October 1998. Hospice, respite care, and rehabilitation patients were excluded. Use of > or = 9 different scheduled medications was defined a priori as routinely administered medications, excluding as-needed agents, topical agents, 1-time administration, and vaccinations. ADRs were identified by voluntary reporting and by chart review during a 12-month period. ADRs were assessed individually by 2 clinical pharmacists applying the Naranjo ADR probability scale. RESULTS: A total of 207 ADRs were identified. The cohort receiving > or = 9 scheduled medications (n = 43) experienced 53 ADRs, compared with 154 ADRs in the control group receiving <9 medications (n = 292). The demographic distribution was similar in both cohorts, with white as the dominant ethnicity; 45% were white in the control group and 51% were white in the cohort group receiving > or = 9 scheduled medications. The sex distribution was also similar, with women outnumbering men in both cohorts: 60% and 81% were women in the control and cohort groups, respectively. The mean age was 72 years (range, 65-100 years). After the data were adjusted for the number of days each subject was at risk for experiencing an ADR, subjects using > or = 9 different scheduled medications were 2.33 times more likely than controls to experience an ADR (95% CI, 1.54-3.52; P < 0.001). CONCLUSION: A positive correlation between the use of >/=9 different scheduled medications and ADRs was found among these geriatric nursing home residents. SN - 1543-5946 UR - https://www.unboundmedicine.com/medline/citation/16730619/Polypharmacy_as_a_risk_factor_for_adverse_drug_reactions_in_geriatric_nursing_home_residents_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1543-5946(06)00003-1 DB - PRIME DP - Unbound Medicine ER -