Register for email alerts and news feeds:
This journal | BMJ Group
rss
Postgraduate Medical Journal 2001;77:703-707; doi:10.1136/pmj.77.913.703
Copyright © 2001 The Fellowship of Postgraduate Medicine.
Postgrad Med J 2001;77:703-707 ( November )

Drug related medical emergencies in the elderly: role of adverse drug reactions and non-compliance

S Malhotraa, R S Karana, P Pandhia, S Jainb

a Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India: Department of Pharmacology, b Department of Internal Medicine

Correspondence to: Dr Pandhi medinst{at}pgi.nic.in

Submitted 10 January 2001; Accepted 27 March 2001

BACKGROUND---Adverse drug reactions and non-compliance are important causes of admissions in the elderly to medical clinics. The contribution of adverse drug reactions and non-compliance to admission by the medical emergency department was analysed.
METHODS---A total of 578 consecutive elderly patients admitted to the medical emergency department were interviewed to determine the percentage of admissions due to adverse drug reactions or non-compliance with medication regimens, their causes, consequences, and predictors.
RESULTS---Eighty three (14.4%) of the 578 admissions were drug related: 39 (6.7%) caused by adverse drug reactions and 44 (7.6%) caused by non-compliance with medication. One hundred ninety two (33.2%) patients had a history of non-compliance. Factors associated with an increased risk of admission because of an adverse drug reaction were patients with diabetes or neoplasms, and patients using numerous different medications. Factors associated with a higher risk of hospitalisation because of non-compliance were poor recall of the medication regimen, seeing numerous physicians, female sex, polypharmacy, drug costs, and switching over to non-conventional forms of treatment.
CONCLUSION---Many elderly admissions are drug related, with non-compliance accounting for a substantial fraction of these. Elderly people at high risk of suffering a drug related medical emergency are identified and suitable interventions may be planned by the healthcare policymakers to target them.


Keywords: adverse drug reactions; non-compliance; drug related medical emergencies; elderly

© 2001 by The Fellowship of Postgraduate Medicine
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

This article has been cited by other articles:

  • Shepherd, G., Schwartz, R. B. (2009). Frequency of incomplete medication histories obtained at triage. Am J Health Syst Pharm 66: 65-69 [Abstract] [Full Text]  
  • Mansur, N., Weiss, A., Beloosesky, Y. (2008). Relationship of In-Hospital Medication Modifications of Elderly Patients to Postdischarge Medications, Adherence, and Mortality. The Annals of Pharmacotherapy 42: 783-789 [Abstract] [Full Text]  
  • Kramer, J. S., Hopkins, P. J., Rosendale, J. C., Garrelts, J. C., Hale, L. S., Nester, T. M., Cochran, P., Eidem, L. A., Haneke, R. D. (2007). Implementation of an electronic system for medication reconciliation. Am J Health Syst Pharm 64: 404-422 [Abstract] [Full Text]  
  • Zed, P. J. (2005). Drug-Related Visits to the Emergency Department. Journal of Pharmacy Practice 18: 329-335 [Abstract]  
  • Ledwidge, M., Travers, B., Ryder, M., Ryan, E., McDonald, K. (2004). Specialist care of heart failure improves appropriate pharmacotherapy at the expense of greater polypharmacy and drug-interactions. Eur J Heart Fail 6: 235-243 [Abstract] [Full Text]  
  • Soljak, M. A, Kendrick, M. E, Laitner, S. M, Law, M., Wald, N. J (2002). Risk factor thresholds. BMJ 325: 1114-1114 [Full Text]  

This Article

Services
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.