Elderly patients with inappropriate medication correlations with adverse drug events or unexpected illnesses in long-term care institutions

Abstract

Introduction: The elderly are subject to natural aging and the health problems caused by the recession of physical and mental functions. Elderly patients are also more susceptible to adverse reactions of medication, drug interactions and other drug problems than the young. We then investigated patients with adverse drug events (ADEs) or unexpected illnesses transferred to our hospital during the whole year of 2010.

Methods: We analyzed the medicine of elderly patients in long-term care institutions. Four long-term care institutions with different types and sizes located near Fong-Yuan Hospital in downtown Fong-Yuan were investigated. In this study, the researchers divided potentially inappropriate medications (PIMs) into two categories: (a) those with or without the drug–drug interaction (DDI) and (b) those with narrow therapeutic index drugs. Variables were reclassified as inferential statistics for analysis by using the independent t-test or Mantel–Haenszel test.

Results: The data for age, gender, presence or absence of dementia, brain damage and Parkinson’s disease were divided into two groups for those patients with or without PIMs. There were no statistically significant differences among the groups. However, the numbers of chronic diseases for the group with PIMs were higher, and the numbers of drug items with PIMs were also higher. In addition, we investigated the presence or absence of PIMs for patients transferred to our hospital with ADEs and unexpected illnesses. The results showed no statistically significant differences among the groups.

Conclusions: Our results showed that elderly patients who had consultations with doctors and the hidden problems about medication were detected by pharmacists in the privileged hospital had no direct risk with DDI or narrow therapeutic index drugs. However, other potential drug risks remain to be further analyzed and more samples should be surveyed.

• Adverse drug event
• inappropriate medication
• long-term care institution
• unexpected illness