Identifying Adverse Drug Events in Older Community-Dwelling Patients

The Article in Brief

Identifying Adverse Drug Events in Older Community-Dwelling Patients

Caitriona Cahir , and colleagues

Background Patient reporting of suspected adverse drug events could increase knowledge about the safety of medication and provide important information to healthcare professionals. This study evaluates a patient-reported instrument for identifying adverse drug events in older adults with multiple medical conditions in the community setting

What This Study Found Older adults often do not recognize a medical symptom as an adverse effect of their medication. In the study, patients 70 years of age or older were asked if they had experienced a list of 74 symptoms in the previous six months and if, (1) they believed the symptom was related to their medication; (2) the symptom had bothered them; (3) they had discussed it with their family physician, and (4) they required hospital care due to the symptom. Self-reported symptoms were independently reviewed by two clinicians who determined the likelihood that the symptom was an adverse drug event. Family physician medical records were also reviewed for any report of an adverse drug event. Among 859 participating patients, 674 (78 percent) were classified as having at least one adverse drug event during the study period. Antithrombotic drugs (intended to reduce the formation of blood clots) were most frequently associated with adverse drug events, with 86 percent of patients prescribed aspirin and warfarin reporting bruising, bleeding, and indigestion. Patients were most bothered by muscle pain and weakness (75 percent), dizziness or lightheadedness (61 percent), and unsteadiness on their feet (52 percent) but did not associate these symptoms with their medication. Patients were less bothered by more prevalent adverse drug events; only 21 percent were bothered by minor hemorrhages from antithrombotic therapy. On average, patients reported 39 percent of adverse drug events to their family physician. Patients who did not do so felt the symptoms were the result of old age and did not want to bother their doctors.

Implications

• The authors call for health information technology and patient outreach programs to manage and track medication symptoms and help patients monitor their medications.