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The Epidemiology of Serious Adverse Drug Reactions Among the Elderly

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Abstract

Although the incidence and prevalence of serious adverse drug reactions (ADRs) in the elderly cannot be accurately stated, published estimates appear to be unchanged since the earliest reports in the 1960s. Whereas heightened awareness of the problem may weigh in favour of a reduction in ADR frequency, the dramatic increase in the number and availability of therapeutic agents has undoubtedly contributed to the observed high proportion of drug-induced morbidity among acute geriatric hospital admissions. No single drug or drug class is of particular concern since none appears to cause serious morbidity out of proportion with its use.

Although numerous studies have sought to identify risk factors for ADRs, the only truly independent predictor is the absolute number of concurrently used medications. However, other studies indicate that there is poor doctor-patient agreement regarding a patient’s drug regimen, and interventions that aim to reduce the incidence of ADRs have failed to demonstrate a positive effect. Thus at present the most rational approach would appear to be to establish an accurate knowledge of the patients drug regimens: once this is known one can attempt to rationally minimise the number of medications without compromising therapeutic goals.

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References

  1. Stewart RB, Caranasos GJ. Medication compliance in the elderly. Med Clin North Am 1989; 73L: 1551–63

    Google Scholar 

  2. Ho PC, Triggs EJ. Drug therapy in the elderly. Aust N Z J Med 1984; 14: 179–90

    Article  PubMed  CAS  Google Scholar 

  3. D’Arcy PF. Drugs and the elderly: an ageing problem. Pharm J 1984; Dec 22 & 29: 784

    Google Scholar 

  4. Schernitski P, Bootman JL, Byers J, et al. Demographic characteristics of elderly drug overdose patients admitted to a hospital emergency department. J Am Geriatr Soc 1980; 28: 544–6

    PubMed  CAS  Google Scholar 

  5. O’Brien JG, Kursch JE. ‘Healthy’ prescribing for the elderly: how to minimize adverse drug effects and prevent ‘dementia in a bottle’. Postgrad Med 1987; 82: 147–151,154,156

    PubMed  Google Scholar 

  6. Cartwright A, Smith C. Elderly people, their medicines, and their doctors. London: Routledge, 1988

    Google Scholar 

  7. Mant A, Whicker S, Kwok YS. Over-the-counter self-medication: the issues. Drugs Aging 1992; 2: 257–61

    Article  PubMed  CAS  Google Scholar 

  8. Anon. Medication risks among the elderly: cures, cautions and consequences. Calif Pharmacist 1990; Dec: 42–7

  9. Atkin PA, Shenfield GM. Medication-related adverse reactions and the elderly: a literature review. Adverse Drug React Toxicol Rev 1995; 14: 175–91

    PubMed  CAS  Google Scholar 

  10. Karch FE, Lasagna L. Adverse drug reactions: a critical review. JAMA 1975; 234: 1236–41

    Article  PubMed  CAS  Google Scholar 

  11. Jick H. Drugs: remarkably nontoxic. N Engl J Med 1974; 291: 824–8

    Article  PubMed  CAS  Google Scholar 

  12. Melmon KL. Preventable drug reactions: causes and cures. N Engl J Med 1971; 284: 1361–8

    Article  PubMed  CAS  Google Scholar 

  13. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalised patients: a meta-analysis of prospective studies. JAMA 1998; 279: 1200–5

    Article  PubMed  CAS  Google Scholar 

  14. Australian Government Publishing Service. National health strategy: issues in pharmaceutical drug use in Australia [abstract]. Canberra: Australian Government Publishing Service, 1992; 4: 33–41

    Google Scholar 

  15. Adverse drug reactions. BMJ 1981; 282: 1819–20

    Google Scholar 

  16. Delafuente JC. Perspectives on geriatric pharmacotherapy. Pharmacotherapy 1991; 11: 222–4

    PubMed  CAS  Google Scholar 

  17. Leape LL, Brennan TA, Laird N, et al. The nature of adverse events in hospitalised patients: results of the Harvard Medical Practice Study II. N Engl J Med 1991; 324: 377–84

    Article  PubMed  CAS  Google Scholar 

  18. Hurwitz N. Admissions to hospital due to drugs. BMJ 1969; 1: 539–40

    Article  PubMed  CAS  Google Scholar 

  19. Hurwitz N, Wade OL. Intensive hospital monitoring of adverse reactions to drugs. BMJ 1969; 1: 531–6

    Article  PubMed  CAS  Google Scholar 

  20. Hurwitz N. Predisposing factors in adverse reactions to drugs. BMJ 1969; 1: 536–9

    Article  PubMed  CAS  Google Scholar 

  21. Davidsen F, Haghfelt T, Gram LF, et al. Adverse drug reactions and drug non-compliance as primary causes of admission to a cardiology department. Eur J Clin Pharmacol 1988; 34: 83–6

    Article  PubMed  CAS  Google Scholar 

  22. World Health Organization (WHO). The WHO Technical Report Series No.498. International drug monitoring: the role of national centres. Geneva: WHO, 1972

    Google Scholar 

  23. World Health Organization. International drug monitoring: the role of the hospital. Drug Intell Clin Pharm 1970; 4: 101

    Google Scholar 

  24. Rawlins MD. Adverse drug reactions. BMJ 1981; 282: 974–6

    Article  PubMed  CAS  Google Scholar 

  25. Rawlins MD, Thompson JW. Pathogenesis of adverse drug reactions. In: Davies DM, editor. Textbook of adverse drug reactions. Oxford: Oxford University Press, 1977: 10–31

    Google Scholar 

  26. Park BK, Coleman JW. The immunological basis of adverse drug reactions: a report on a symposium held in Liverpool on 6th April 1988. Br J Clin Pharmacol 1988; 26: 491–5

    Article  PubMed  CAS  Google Scholar 

  27. Girard M. Conclusiveness of rechallenge in the interpretation of adverse drug reactions. Br J Clin Pharmacol 1987; 23: 73–9

    Article  PubMed  CAS  Google Scholar 

  28. Karch FE, Lasagna L. Towards the operational identification of adverse drug reactions. Clin Pharmacol Ther 1977; 21: 247–54

    PubMed  CAS  Google Scholar 

  29. Karch FE, Smith CL, Kerzner B, et al. Adverse drug reactions: a matter of opinion. Clin Pharmacol Ther 1976; 19: 489–92

    PubMed  CAS  Google Scholar 

  30. Koch-Weser J, Sellers EM, Zacest R. The ambiguity of adverse drug reactions. Eur J Clin Pharmacol 1977; 11: 75–8

    Article  PubMed  CAS  Google Scholar 

  31. Kramer MS, Leventhal JM, Hutchinson TA, et al. An algorithm for the operational assessment of adverse drug reactions: background description and instructions for use. JAMA 1979; 242: 623–32

    Article  PubMed  CAS  Google Scholar 

  32. Lanctot KL, Naranjo CA. Comparison of the Bayesian approach and a single algorithm for assessment of adverse drug events. Clin Pharmacol Ther 1995; 58: 692–8

    Article  PubMed  CAS  Google Scholar 

  33. Lanctot KL, Naranjo CA. Computer-assisted evaluation of adverse events using a Bayesian approach. J Clin Pharmacol 1994; 34: 142–7

    PubMed  CAS  Google Scholar 

  34. Ives TJ, Bentz EJ, Gwyther RE. Drug related admissions to a family medicine in-patient service. Arch Intern Med 1987; 147: 1117–20

    Article  PubMed  CAS  Google Scholar 

  35. Naranjo CA, Shear NH, Lanctot KL. Advances in the diagnosis of adverse drug reactions. J Clin Pharmacol 1992; 32: 897–904

    PubMed  CAS  Google Scholar 

  36. Lee A, Rawlins MD, Smith JM. A study of expert judgements on adverse drug reaction reports, and comparison with algorithmic methods [abstract]. Br J Clin Pharmacol 1992; 34: 157

    Google Scholar 

  37. Hoigne R, Lawson DH, Weber E. Risk factors for adverse drug reactions-epidemiological approaches. Eur J Clin Pharmacol 1990; 39: 321–5

    Article  PubMed  CAS  Google Scholar 

  38. Atkin PA, Finnegan TP, Ogle SJ, et al. Prevalence of drug related admissions to a hospital geriatric service. Aust J Ageing 1994; 13: 17–21

    Article  Google Scholar 

  39. Colt HG, Shapiro AP. Drug induced illness as a cause for admission to a community hospital. J Am Geriatr Soc 1989; 37: 323–6

    PubMed  CAS  Google Scholar 

  40. Castleden CM, Pickles H. Suspected adverse drug reactions in elderly patients reported to the Committee in Safety of Medicines. Br J Clin Pharmacol 1988; 26: 347–53

    Article  PubMed  CAS  Google Scholar 

  41. Williamson J, Chopin JM. Adverse reactions to prescribed drugs in the elderly: a multicentre investigation. Age Ageing 1980; 9: 73–80

    Article  PubMed  CAS  Google Scholar 

  42. Leach S, Roy SS. Adverse drug reactions: an investigation on an acute geriatric ward. Age Ageing 1986; 15: 241–6

    Article  PubMed  CAS  Google Scholar 

  43. Shimp LA, Ascione FJ, Glazer HM, et al. Potential medication-related problems in noninstitutionalised elderly. Drug Intell Clin Pharm 1985; 19: 766–72

    PubMed  CAS  Google Scholar 

  44. Bergman U, Wiholm BE. Drug related problems causing admission to a medical clinic. Eur J Clin Pharmacol 1981; 20: 193–200

    Article  PubMed  CAS  Google Scholar 

  45. Hallas J, Gram LF, Grodum E, et al. Drug related admissions to medical wards: a population based survey. Br J Clin Pharmacol 1992; 33: 61–8

    Article  PubMed  CAS  Google Scholar 

  46. Smith JW, Seidl LG, Cluff LE. Studies on the epidemiology of adverse drug reactions. Ann Intern Med 1966; 65: 629–34

    PubMed  CAS  Google Scholar 

  47. Bax DE, Woods HS, Christie J, et al. Therapeutic audit on a general medical ward [abstract]. Clin Sci 1987; 72Suppl. 16: 29

    Google Scholar 

  48. Burns E, Wyld PJ, Bax NDS. Doctors’ and patient’s perception of adverse drug reactions in a general medical and an anticoagulant clinic. J R Coll Physicians Lond 1988; 22: 248–51

    PubMed  CAS  Google Scholar 

  49. Bax NDS, Richards RK, Woods HS, et al. Adverse drug reactions in elderly patients in hospital [abstract]. Br J Clin Pharmacol 1987; 25: 94

    Google Scholar 

  50. Cadieux RJ. Drug interactions in the elderly: how multiple drug use increases risk exponentially. Postgrad Med 1989; 86: 179–86

    PubMed  CAS  Google Scholar 

  51. Brawn LA, Castleden CM. Adverse drug reactions: an overview of special considerations in the management of the elderly patient. Drug Saf 1990; 5: 421–35

    Article  PubMed  CAS  Google Scholar 

  52. Ramsay LE, Tucker GT. Clinical pharmacology: drugs and the elderly. BMJ 1981; 282: 125–7

    Article  PubMed  CAS  Google Scholar 

  53. Hansson L, Zanchetti A. The hypertension optimal treatment (HOT) study: 12-month data on blood pressure and tolerability with special reference to age and gender. Blood Press 1995; 4: 313–9

    Article  PubMed  CAS  Google Scholar 

  54. Croog S, Levine S, Testa M, et al. The effects of antihypertensive therapy on the quality of life. N Engl J Med 1986; 314: 1657–64

    Article  PubMed  CAS  Google Scholar 

  55. Kaplan N. Diuretics: cornerstone of antihypertensive therapy. Am J Cardiol 1996; 77: 3B–5

    Article  PubMed  CAS  Google Scholar 

  56. Hume A, Barbour M, Willey C, et al. Changing trends in antihypertensive therapy in two New England communities during the 1980s. Pharmacotherapy 1993; 13: 244–51

    PubMed  CAS  Google Scholar 

  57. Tamblyn R, Berkson L, Dauphinee W, et al. Unnecessary prescribing of NSAIDs and the management of NSAID-related gastropathy in medical practice. Ann Intern Med 1997; 127: 429–38

    PubMed  CAS  Google Scholar 

  58. Henry DA, Day RO. Do anti-ulcer drugs prevent gastrointestinal damage from NSAIDs? Aust Prescr 1991; 14: 42–3

    Google Scholar 

  59. McManus P, Primrose JG, Henry DA, et al. Pattern of nonsteroidal anti-inflammatory drug use in Australia 1990–1994: a report from the drug utilisation subcommitte of the pharmaceutical benefits advisory committee. Med J Aust 1996; 164: 589–92

    PubMed  CAS  Google Scholar 

  60. Henry DA, Dobson A, Turner C. Variability in the risk of major gastro-intestinal complications from non-aspirin non-steroidal anti-inflammatory drugs. Gastroenterology 1993; 105: 1078–88

    PubMed  CAS  Google Scholar 

  61. Somerville K, Falkner G, Langman M. Non-steroidal anti-inflammatory drugs and bleeding peptic ulcer. Lancet 1986; I: 462–4

    Article  Google Scholar 

  62. Rodriquez L, Jick H. Risk of upper gastro-intestinal bleeding and perforation associated with individual non-steroidal anti-inflammatory drugs. Lancet 1994; 343: 769–72

    Article  Google Scholar 

  63. Griffin M, Ray W, Schaffner W. Non-steroidal anti-inflammatory drug use and death from peptic ulcer in elderly persons. Ann Intern Med 1988; 109: 359–63

    PubMed  CAS  Google Scholar 

  64. Girdwood R. Death after taking medicaments. BMJ 1974; 1: 501–4

    Article  PubMed  CAS  Google Scholar 

  65. Fries J, Miller S, Spitz P, et al. Towards an epidemiology of gastropathy associated with non-steroidal anti-inflammatory drug use. Gastroenterology 1989; 96: 647–55

    PubMed  CAS  Google Scholar 

  66. Griffin M, Piper J, Dougherty J, et al. Non-steroidal anti-inflammatory drug use and increased risk for peptic ulcer disease in elderly persons. Ann Intern Med 1991; 114: 257–63

    PubMed  CAS  Google Scholar 

  67. Tinetti M, Speechley M, Ginter S. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319: 1701–7

    Article  PubMed  CAS  Google Scholar 

  68. Cumming R, Miller J, Kelsey J, et al. Medications and multiple falls in elderly people: the St Louis OASIS study. Age Ageing 1991; 20: 455–61

    Article  PubMed  CAS  Google Scholar 

  69. Lord S, Sambrook P, Gilbert C, et al. Postural stability, falls and fractures in the elderly: results of the Dubbo osteoporosis epidemiology study. Med J Aust 1994; 160: 684–91

    PubMed  CAS  Google Scholar 

  70. Ray W, Griffin M, Schaffner W, et al. Psychotic drug use and the risk of hip fracture. N Engl J Med 1987; 316: 363–9

    Article  PubMed  CAS  Google Scholar 

  71. Gurwitz JH, Soumerai SB, Avorn J. Improving medication prescribing and utilization in the nursing home. J Am Geriatr Soc 1990; 38: 542–52

    PubMed  CAS  Google Scholar 

  72. Waxman H, Klein M, Carner E. Drug misuse in nursing homes: an institutional addiction? Hosp Community Psychiatry 1985; 36: 886–7

    PubMed  CAS  Google Scholar 

  73. Campbell AJ, McCosh L, Reinken J. Drugs taken by a population based sample of subjects 65 years and over in New Zealand. NZ Med J 1983; 96: 378–80

    CAS  Google Scholar 

  74. Snowden J, Vaughan R, Miller R, et al. Psychotropic drug use in Sydney nursing homes. Med J Aust 1995; 163: 70–2

    Google Scholar 

  75. Nolan L, O’Malley K. The need for a more rational approach to drug prescribing for elderly people in nursing homes. Age Ageing 1989; 18: 52–6

    Article  PubMed  CAS  Google Scholar 

  76. Beers MH, Avorn J, Soumerai SB, et al. Psychoactive medication use in intermediate-care facility residents. JAMA 1988; 260: 3016–20

    Article  PubMed  CAS  Google Scholar 

  77. Gurwitz JH, Avorn J. The ambiguous relation between aging and adverse drug reactions. Ann Intern Med 1991; 114: 956–66

    PubMed  CAS  Google Scholar 

  78. Greenblatt DS, Sellers EM, Shader RI. Drug disposition in old age. N Engl J Med 1982; 306: 1081–8

    Article  PubMed  CAS  Google Scholar 

  79. Smith TW, Haber E. Digoxin intoxication: the relationship of clinical presentation to serum digoxin concentration. J Clin Invest 1970; 49: 2377–86

    Article  PubMed  CAS  Google Scholar 

  80. Montamat SC, Cusack BJ, Vestal RE. Management of drug therapy in the elderly. N Engl J Med 1989; 321: 303–9

    Article  PubMed  CAS  Google Scholar 

  81. Nolan L, O’Malley K. Prescribing for the elderly: I. sensitivity of the elderly to adverse drug reactions. J Am Geriatr Soc 1988; 36: 142–9

    PubMed  CAS  Google Scholar 

  82. Denham MJ. Adverse drug reactions. Br Med Bull 1990; 46: 53–62

    PubMed  CAS  Google Scholar 

  83. Grymonpre RE, Mitenko PA, Sitar DS, et al. Drug-associated hospital admissions in older patients. J Am Geriatr Soc 1988; 36: 1092–8

    PubMed  CAS  Google Scholar 

  84. Ioannides-Demos LL, Christophidis N. Adverse drug reactions and the elderly. Aust J Hosp Pharm 1993; 23: 411–6

    Google Scholar 

  85. Blazer II DG, Federspiel CF, Ray WA, et al. The risk of anticholinergic toxicity in the elderly: a study of prescribing practices in two populations. J Gerontol 1983; 38: 31–5

    PubMed  Google Scholar 

  86. Australian Government Publishing Service. Adverse drug reactions. In: Another side of the drug debate … a medicated society? Report from the Senate Standing Committee on Social Welfare. Canberra: Australian Government Publishing Service, 1981: 107–14

    Google Scholar 

  87. Swift CG. Prescribing in old age. BMJ 1988; 296: 913–5

    Article  PubMed  CAS  Google Scholar 

  88. O’Connor P, Moriarty JM, Feely J. Adverse drug reactions-incentives to enhanced reporting [abstract]. Br J Clin Pharmacol 1988; 26: 616P–7

    Google Scholar 

  89. Hallas J, Haghfelt T, Gram LF, et al. Drug related admissions to a cardiology department; frequency and avoidability. J Intern Med 1990; 228: 379–84

    Article  PubMed  CAS  Google Scholar 

  90. Sachs RM, Bortnichak EA. An evaluation of spontaneous adverse drug reaction monitoring systems. Am J Med 1986; 81: 49–55

    PubMed  CAS  Google Scholar 

  91. Waller PC. Measuring the frequency of adverse drug reactions. Br J Clin Pharmacol 1992; 33: 249–52

    Article  PubMed  CAS  Google Scholar 

  92. Larmour I, Dolphin RG, Baxter H, et al. Aprospective study of hospital admissions due to drug reactions. Aust J Hosp Pharm 1991; 21: 90–5

    Google Scholar 

  93. Einarson TR. Drug-related hospital admissions. Ann Pharmacother 1993; 27: 832–40

    PubMed  CAS  Google Scholar 

  94. Michocki RJ, Lamy PP. A ‘risk’ approach to adverse drug reaction. J Am Geriatr Soc 1988; 36: 79–81

    PubMed  CAS  Google Scholar 

  95. Trunet P, LeGall J, Lhoste F, et al. The role of iatrogenic disease in admission to intensive care. JAMA 1980; 244: 2617–20

    Article  PubMed  CAS  Google Scholar 

  96. Hallas J, Jensen KB, Grodum E, et al. Drug-related admissions to a department of medical gastroenterology; the role of self-medicated and prescribed drugs. Scand J Gastroenterol 1991; 26: 174–80

    Article  PubMed  CAS  Google Scholar 

  97. Atkin PA, Finnegan TP, Ogle SJ, et al. Are medication record cards useful? Med J Aust 1995; 162: 300–1

    PubMed  CAS  Google Scholar 

  98. Zilleruelo I, Espinoza E, Ruiz I. Influence of the assessment of the severity on the frequency of adverse drug reactions (ADRs). Int J Clin Pharmacol Ther Toxicol 1987; 25: 328–33

    PubMed  CAS  Google Scholar 

  99. Caranasos GJ, Stewart RB, Cluff LE. Drug-induced illness leading to hospitalization. JAMA 1974; 228: 713–7

    Article  PubMed  CAS  Google Scholar 

  100. Miller RR. Hospital admissions due to adverse drug reactions: a report from the Boston Collaborative Drug Surveillance Program. Arch Intern Med 1974; 134: 219–23

    Article  PubMed  CAS  Google Scholar 

  101. Levy M, Lipshitz M, Eliakim M. Hospital admissions due to adverse drug reactions. Am J Med Sci 1979; 277: 49–56

    Article  PubMed  CAS  Google Scholar 

  102. Col N, Fanale JE, Kronholm P. The role of medication noncompliance and adverse drug reactions in hospitalisations of the elderly. Arch Intern Med 1990; 150: 841–5

    Article  PubMed  CAS  Google Scholar 

  103. Kennedy M, Collits B, Wu M, et al. Adverse drug reactions attending the emergency department [abstract]. Clin Exp Pharmacol Physiol 1993; Suppl. 1: 38

    Google Scholar 

  104. Stanton LA, Peterson GM, Rumble RH, et al. Drug-related admissions to an Australian hospital. J Clin Pharm Ther 1994; 19: 341–7

    Article  PubMed  CAS  Google Scholar 

  105. Van-Kraaij DJ, Haagsma CJ, Go IH, et al. Drug use and adverse drug reactions in 105 elderly patients admitted to a general medical ward. Neth J Med 1994; 44: 166–73

    Article  PubMed  CAS  Google Scholar 

  106. Dartnell JG, Anderson RP, Chohan V, et al. Hospitalisation for adverse events related to drug therapy: incidence, avoidability and costs. Med J Aust 1996; 164: 659–62

    PubMed  CAS  Google Scholar 

  107. Jick H. The discovery of drug-induced illness. N Engl J Med 1977; 296: 481–5

    Article  PubMed  CAS  Google Scholar 

  108. Pauker SG, Kassirer JP. Therapeutic decision making: a cost benefit analysis. N Engl J Med 1975; 293: 229–34

    Article  PubMed  CAS  Google Scholar 

  109. Weston JK. The present status of adverse drug reaction reporting. JAMA 1968; 203: 35–7

    Article  PubMed  CAS  Google Scholar 

  110. Jankel CA, Fitterman LK. Epidemiology of drug-drug interactions as a cause of hospital admission. Drug Saf 1993; 9: 51–9

    Article  PubMed  CAS  Google Scholar 

  111. Nelson KM, Talbert RL. Drug-related hospital admissions. Pharmacotherapy 1996; 16: 701–7

    PubMed  CAS  Google Scholar 

  112. Scharf S, Christophidis N. Prescribing for the elderly: I. relevance of pharmacokinetics and pharmacodynamics. Med J Aust 1993; 158: 395–402

    PubMed  CAS  Google Scholar 

  113. Dobbs RJ, Dobbs SM, Weller C. Clinical pharmacology, therapeutics and geriatric medicine: an interaction of importance. Br J Clin Pharmacol 1991; 32: 405–6

    Article  PubMed  CAS  Google Scholar 

  114. Cadigan DA, Magaziner J, Fedder DO. Polymedicine use among community resident older women: how much a problem? Am J Public Health 1989; 79: 1537–40

    Article  PubMed  CAS  Google Scholar 

  115. Levy M, Nir J, Birnbaum D, et al. Adverse reactions to drugs in hospitalised medical patients. Isr J Med Sci 1973; 9: 617–26

    PubMed  CAS  Google Scholar 

  116. Smith JW, Seidl LG, Cluff LE. Studies on the epidemiology of adverse drug reactions: V. clinical factors influencing the susceptibility. Ann Intern Med 1966; 65: 629–40

    PubMed  CAS  Google Scholar 

  117. Levy M, Kewitz N, Altwein W, et al. Hospital admissions due to adverse drug reactions: a comparative study from Jerusalem and Berlin. Eur J Clin Pharmacol 1980; 17: 25–31

    Article  PubMed  CAS  Google Scholar 

  118. Bergman U, Wiholm BE. Patient medication on admission to a medical clinic. Eur J Clin Pharmacol 1981; 20: 1–7

    Article  Google Scholar 

  119. Crooks J. Rational therapeutics in the elderly. J Chronic Dis 1983; 36: 59–65

    Article  PubMed  CAS  Google Scholar 

  120. Weintraub M, Singh S, Byrne L, et al. Consequences of the 1989 New York State triplicate benzodiazepine prescription regulations. JAMA 1991; 266: 2392–7

    Article  PubMed  CAS  Google Scholar 

  121. Soumerai SB, Ross-Degnan D, Avorn J, et al. Effects of Medicaid drug-payment limits on admission to hospitals and nursing homes. N Engl J Med 1991; 325: 1072–7

    Article  PubMed  CAS  Google Scholar 

  122. Carroll NV, Erwin WG. Effect of the prospective-pricing system on drug use in Pennsylvania long term care facilities. Am J Hosp Pharm 1990; 47: 2251–4

    PubMed  CAS  Google Scholar 

  123. Soumerai SB, Avorn J, Ross-Degnan D, et al. Payment restrictions for prescription drugs under Medicaid: effects on therapy, cost and equity. N Engl J Med 1987; 317: 550–6

    Article  PubMed  CAS  Google Scholar 

  124. Lamy PP. Pharmacotherapeutics in the elderly. Md Med J 1989; 38: 144–8

    PubMed  CAS  Google Scholar 

  125. Gibbins FJ, Sen I, Vaz FS, et al. Clinical budgeting and drug management on long-stay geriatric wards. Age Ageing 1988; 17: 328–3

    Article  PubMed  CAS  Google Scholar 

  126. Atkin PA, Shenfield GM. How many medications do elderly patients really take? Aust J Hosp Pharm 1993; 23: 109–13

    Google Scholar 

  127. Gilchrist WJ, Lee YC, Tam HC, et al. Prospective study of drug reporting by general practitioners for an elderly population referred to a geriatric service. BMJ 1987; 294: 289–90

    Article  PubMed  CAS  Google Scholar 

  128. Atkin PA, Stringer RS, Duffy JB, et al. The influence of information provided by patients on the accuracy of medication records [published erratum appears in Med J Aust 169 (9): 468]. Med J Aust 1998; 169(2): 85–8

    PubMed  CAS  Google Scholar 

  129. Law R, Chalmers C. Medicines and elderly people: a general practice survey. BMJ 1976; 1: 565–8

    Article  PubMed  CAS  Google Scholar 

  130. Penner M, Dicker M, Ens S. Using postcards to increase patient provided information on medication use. Fam Med 1991; 23: 44–5

    PubMed  CAS  Google Scholar 

  131. Shaw PG. Common pitfalls in geriatric drug prescribing. Drugs 1982; 23: 324–8

    Article  PubMed  CAS  Google Scholar 

  132. Hendriksen C, Lund E, Stromgard E. Intake of drugs among elderly people in a Danish Municipality, Rodovre. Acta Med Scand 1983; 214: 67–71

    Article  PubMed  CAS  Google Scholar 

  133. Lamy PP. Hazards of drug use in the elderly: commonsense measures to reduce them. Postgrad Med 1984; 76: 50–3, 56–7, 60–1

    PubMed  CAS  Google Scholar 

  134. Kessler DA. Sounding board: communicating with patients about their medications. N Engl J Med 1991; 325: 1650–2

    Article  PubMed  CAS  Google Scholar 

  135. Omori DM, Potyk RP, Kroenke K. The adverse effects of hospitalization on drug regimens. Arch Intern Med 1991; 151: 1562–4

    Article  PubMed  CAS  Google Scholar 

  136. Lakshmanan MC, Hershey CO, Breslau D. Hospital admission caused by iatrogenic disease. Arch Intern Med 1986; 146: 1931–4

    Article  PubMed  CAS  Google Scholar 

  137. Baskett JJ. Prescribing for the elderly I: an exercise in care and rationalisation. Curr Ther 1992; August: 49–56

    Google Scholar 

  138. Fox FJ, Auestad AE. Geriatric emergency clinical pharmacology. Emerg Med Clin North Am 1990; 8: 221–39

    PubMed  CAS  Google Scholar 

  139. Patterson C. Iatrogenic disease in late life. Clin Geriatr Med 1986; 2: 121–36

    PubMed  CAS  Google Scholar 

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Atkin, P.A., Veitch, P.C., Veitch, E.M. et al. The Epidemiology of Serious Adverse Drug Reactions Among the Elderly. Drugs Aging 14, 141–152 (1999). https://doi.org/10.2165/00002512-199914020-00005

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