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Adverse Drug Reactions in Older People

Detection and Prevention

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Abstract

Adverse drug reactions (ADRs) in older adults are an important healthcare problem since they are frequently a cause of hospitalization, occur commonly during admission, and are an important cause of morbidity and mortality. Older adults are particularly susceptible to ADRs because they are usually on multiple drug regimens and because age is associated with changes in pharmacokinetics and pharmacodynamics.

The presentation of an ADR in older adults is often atypical, which further complicates its recognition. One potential strategy for improving recognition of ADRs is to identify those patients who are at risk of an ADR. The recently developed GerontoNet ADR Risk Score is a practical tool for identification of older patients who are at increased risk for an ADR and who may represent a target for interventions aimed at reducing ADRs.

Provision of adequate education in the domain of clinical geriatric pharmacology can improve recognition of ADRs. Besides formal surveillance systems, built-in computer programs with electronic prescribing databases and clinical pharmacist involvement in patient care within multidisciplinary geriatric teams might help to minimize the occurrence of ADRs. In addition, a number of actions can be taken in hospitals to stimulate appropriate prescribing and to assure adequate communication between primary and hospital care. In older adults with complex medical problems and needs, a global evaluation obtained through a comprehensive geriatric assessment may be helpful in simplifying drug prescription and prioritizing pharmacological and healthcare needs, resulting in an improvement in quality of prescribing.

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Acknowledgements

No sources of funding were used to assist in the preparation of this article. The authors have no conflicts of interest that are directly relevant to the content of this article.

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Authors and Affiliations

  1. Department of Geriatrics, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium

    Mirko Petrovic

  2. Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands

    Tischa van der Cammen

  3. Department of Geriatrics, Policlinico A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy

    Graziano Onder

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  1. Mirko Petrovic
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  2. Tischa van der Cammen
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  3. Graziano Onder
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Correspondence to Mirko Petrovic.

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Petrovic, M., van der Cammen, T. & Onder, G. Adverse Drug Reactions in Older People. Drugs Aging 29, 453–462 (2012). https://doi.org/10.2165/11631760-000000000-00000

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