@article {Dohertye211, author = {Ann S Doherty and Fiona Boland and Frank Moriarty and Tom Fahey and Emma Wallace}, title = {Adverse drug reactions and associated patient characteristics in older community-dwelling adults: a 6-year prospective cohort study}, volume = {73}, number = {728}, pages = {e211--e219}, year = {2023}, doi = {10.3399/BJGP.2022.0181}, publisher = {Royal College of General Practitioners}, abstract = {Background To date, research on adverse drug reactions (ADRs) has focused on secondary care, and there is a paucity of studies that have prospectively examined ADRs affecting older adults in general practice.Aim To examine the cumulative incidence and severity of ADRs and associated patient characteristics in a sample of community-dwelling older adults.Design and setting Prospective cohort study of older adults (aged >=70 years, N = 592) recruited from 15 general practices in the Republic of Ireland.Method Manual review of the participant{\textquoteright}s general practice electronic medical record, linked to the national dispensed prescription medicine database, and a detailed, self-reported patient postal questionnaire. The primary outcomes were ADR occurrence and severity over a 6-year period (2010{\textendash}2016). Unadjusted and adjusted logistic regression models examined potential associations between patient characteristics and ADR occurrence.Results A total of 211 ADRs were recorded for 159 participants, resulting in a cumulative incidence of 26.9\% over 6 years. The majority of ADRs detected were mild (89.1\%), with the remainder classified as moderate (10.9\%). Eight moderate ADRs, representing 34.8\% of moderate ADRs and 3.8\% of all ADRs, required an emergency hospital admission. ADRs were independently associated with female sex (adjusted odds ratio [OR] 1.83, 95\% confidence interval [CI] = 1.17 to 2.85; P = 0.008), polypharmacy (5{\textendash}9 drug classes) (adjusted OR 1.81, 95\% CI = 1.17 to 2.82; P = 0.008), and major polypharmacy (>=10 drug classes) (adjusted OR = 3.33, 95\% CI = 1.62 to 6.85; P = 0.001).Conclusion This prospective cohort study of ADRs in general practice shows that over one-quarter of older adults experienced an ADR over a 6-year period. Polypharmacy is independently associated with ADR risk in general practice and older adults on >=10 drug classes should be prioritised for regular medication review.}, issn = {0960-1643}, URL = {https://bjgp.org/content/73/728/e211}, eprint = {https://bjgp.org/content/73/728/e211.full.pdf}, journal = {British Journal of General Practice} }