Expected and actual adverse drug-drug interactions in elderly patients accessing the emergency department: data from the ANCESTRAL-ED study

Expert Opin Drug Saf. 2016 Dec;15(sup2):45-50. doi: 10.1080/14740338.2016.1221400.

Abstract

Objective: This study was aimed at evaluating the frequency and describing the adverse drug-drug interactions (DDIs) recorded among elderly patients accessing the emergency department (ED).

Methods: Patients aged ≥65 years, accessing the ED of Pisa University Hospital (Italy) from 1 January 2015 to 31 December 2015 within the ANCESTRAL-ED program, were included in this study. 'Expected' DDIs were assessed using Thomson Micromedex®. Each ED admission (discharge diagnosis) consistent with the signs and symptoms of an expected DDI for each patient was classified as an 'actual' DDI.

Results: Throughout the study period, 3473 patients (3812 ED admissions, 58% females, mean age: 80.3) were recorded. The total number of expected DDIs was 12,578 (67 contraindicated; 3334 major; 8878 moderate; 299 minor) detected in 2147 (62%) patients. Overall 464 expected DDIs were found to be consistent with the ED admission in 194 patients (representing 9% of patients with expected DDIs).

Conclusions: More than one half of elderly patients admitted to ED presented at least one expected DDI at the time of ED presentation. However, 9% of the expected DDIs were identified as actual DDIs, based on the consistency of the expected event with the ED discharge diagnosis.

Keywords: Elderly patients; adverse drug reactions; drug-drug interactions; emergency department.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Drug Interactions*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Emergency Service, Hospital*
  • Female
  • Hospitals, University
  • Humans
  • Italy / epidemiology
  • Male
  • Prospective Studies