Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications.
Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications.
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DOI：
10.1111/jgs.12504
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发表时间：
2013-11
影响因子：
6.3
通讯作者：
Gurwitz JH
中科院分区：
文献类型：
--
作者：
Kanaan AO;Donovan JL;Duchin NP;Field TS;Tjia J;Cutrona SL;Gagne SJ;Garber L;Preusse P;Harrold LR;Gurwitz JH
描述老年人住院后高风险45天内发生的药物不良事件（ADE）。临床药师回顾了1000例连续出院的门诊记录。一个大型的多专业团体实践与马萨诸塞州的健康计划密切相关。出院回家的65岁及以上住院患者。确定了住院后45天内发生的可能的药物相关事件，并提交给两名医生审查员，他们根据是否存在ADE、事件是否可预防以及事件的严重程度对事件进行分类。根据纳入2012年Beers老年人潜在不适当用药标准的情况，进一步描述了与ADE相关的药物。在45天期间，18.7%（187例）的1000例出院病例中至少发现1起ADE。在确定的242起ADE中，35%（n=84）被认为是可预防的，其中32%（n=27）被描述为严重，5%（n=4）被描述为危及生命。超过一半的ADE发生在住院后的前14天内。涉及Beers标准药物的ADE百分比为16.5%（n=40）。具有高质量证据和强推荐强度的Beers标准药物与6.6%（n=16）的ADE有关。ADE在老年人出院后很常见，而且通常是可以预防的，这强调了在这一高危人群中解决药物安全问题的必要性。啤酒标准药物在这些事件中发挥了很小的作用，这表明在这个关键的过渡时期，提高药物使用的质量和安全性的努力必须超越对啤酒标准药物的单一关注。
To characterize adverse drug events (ADEs) occurring within the high-risk 45-day period post-hospitalization in older adults. Clinical pharmacists reviewed the ambulatory records of 1000 consecutive discharges. A large multispecialty group practice closely aligned with a Massachusetts-based health plan. Hospitalized patients aged 65 years and older who were discharged to home. Possible drug-related incidents occurring during the 45-day period post-hospitalization were identified and presented to a pair of physician-reviewers who classified incidents as to whether an ADE was present, whether the event was preventable, and the severity of the event. Medications implicated in ADEs were further characterized according to their inclusion in the 2012 Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. At least one ADE was identified during the 45-day period in 18.7% (187) of the 1000 discharges. Of the 242 ADEs identified, 35% (n=84) were deemed preventable, of which 32% (n=27) were characterized as serious, and 5% (n=4) as life threatening. Over half of all ADEs occurred within the first 14 days post-hospitalization. The percentage of ADEs in which Beers Criteria medications were implicated was 16.5% (n=40). Beers Criteria medications with both a high quality of evidence and strong strength of recommendation were implicated in 6.6% (n=16) of the ADEs. ADEs are common and often preventable among older adults following hospital discharge, underscoring the need to address medication safety during this high-risk period in this vulnerable population. Beers Criteria medications played a small role in these events suggesting that efforts to improve the quality and safety of medication use during this critical transition period must extend beyond a singular focus on Beers criteria medications.
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DOI：
10.1046/j.1532-5415.2003.51185.x
发表时间：
2003-04-01
影响因子：
6.3
作者：
Coleman, EA
通讯作者：
Coleman, EA
影响因子：
5.7
作者：
Forster, AJ;Murff, HJ;Bates, DW
通讯作者：
Bates, DW
影响因子：
120.7
作者：
Leape, LL;Cullen, DJ;Bates, DW
通讯作者：
Bates, DW
DOI：
10.1111/j.1532-5415.1989.tb02227.x
发表时间：
1989-08-01
影响因子：
6.3
作者：
BEERS, MH;DANG, J;TAMAI, IY
通讯作者：
TAMAI, IY
影响因子：
120.7
作者：
Bates, DW;Leape, LL;Seger, DL
通讯作者：
Seger, DL