Antihypertensive-related adverse drug reactions among older hospitalized adults

Alhawassi, TM; Krass, I; Pont, LG

Antihypertensive-related adverse drug reactions among older hospitalized adults

Alhawassi, TM Krass, I Pont, LG

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Publication Type:: Journal Article
Citation:: International Journal of Clinical Pharmacy, 2018, 40 (2), pp. 428 - 435
Issue Date:: 2018-04-01

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Field	Value	Language
dc.contributor.author	Alhawassi, TM	en_US
dc.contributor.author	Krass, I	en_US
dc.contributor.author	Pont, LG https://orcid.org/0000-0002-8545-716X	en_US
dc.date.available	2017-12-20	en_US
dc.date.issued	2018-04-01	en_US
dc.identifier.citation	International Journal of Clinical Pharmacy, 2018, 40 (2), pp. 428 - 435	en_US
dc.identifier.issn	2210-7703	en_US
dc.identifier.uri	http://hdl.handle.net/10453/128260
dc.description.abstract	© 2018, Springer International Publishing AG, part of Springer Nature. Background Antihypertensive medications are commonly used for a wide range of indications, yet it is unknown to what extent older adults are at risk of adverse drug reactions (ADRs) associated with their antihypertensive medication use. Objective The aim of this study was to determine the prevalence and characteristics of antihypertensive-related ADRs on hospital admission. Setting Metropolitan teaching hospital in Sydney, Australia. Method A retrospective cross-sectional audit of 503 older patients (≥ 65 years) admitted to hospital was conducted. Potential ADRS were identified from the medical record. Two independent clinical pharmacists reviewed each potential ADR using validated tools for causality, severity, preventability and contribution to hospitalization. Characteristics associated with an increased ADR risk among antihypertensive users were identified via logistic regression. Main outcome measure Antihypertensive related ADRs. Results Antihypertensives were used on admission by 68% of the cohort and the prevalence of ‘definite/probable’ antihypertensive-related ADRs among antihypertensive users was 16.4%. Antihypertensive medications were associated with a threefold ADR risk (OR = 3.09, 95% CI 1.85–5.16). Angiotensin II Receptor Blockers (ARB), impaired renal function, recent medication changes and previous history of allergy or ADR were all associated with an increased risk of experiencing an ADR. Conclusions ADRS associated with antihypertensive medicines were relatively common among older adults admitted to hospital. Increased awareness of those older persons who are most at risk of experiencing an antihypertensive-related ADR in the clinical setting may lead to early detection and minimization of ADR associated harms.	en_US
dc.relation.ispartof	International Journal of Clinical Pharmacy	en_US
dc.relation.isbasedon	10.1007/s11096-017-0583-7	en_US
dc.subject.classification	Pharmacology & Pharmacy	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Antihypertensive Agents	en_US
dc.subject.mesh	Hospitalization	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Cohort Studies	en_US
dc.subject.mesh	Cross-Sectional Studies	en_US
dc.subject.mesh	Age Factors	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Drug-Related Side Effects and Adverse Reactions	en_US
dc.title	Antihypertensive-related adverse drug reactions among older hospitalized adults	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	40	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
utslib.for	1199 Other Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	40	en_US

Abstract:

© 2018, Springer International Publishing AG, part of Springer Nature. Background Antihypertensive medications are commonly used for a wide range of indications, yet it is unknown to what extent older adults are at risk of adverse drug reactions (ADRs) associated with their antihypertensive medication use. Objective The aim of this study was to determine the prevalence and characteristics of antihypertensive-related ADRs on hospital admission. Setting Metropolitan teaching hospital in Sydney, Australia. Method A retrospective cross-sectional audit of 503 older patients (≥ 65 years) admitted to hospital was conducted. Potential ADRS were identified from the medical record. Two independent clinical pharmacists reviewed each potential ADR using validated tools for causality, severity, preventability and contribution to hospitalization. Characteristics associated with an increased ADR risk among antihypertensive users were identified via logistic regression. Main outcome measure Antihypertensive related ADRs. Results Antihypertensives were used on admission by 68% of the cohort and the prevalence of ‘definite/probable’ antihypertensive-related ADRs among antihypertensive users was 16.4%. Antihypertensive medications were associated with a threefold ADR risk (OR = 3.09, 95% CI 1.85–5.16). Angiotensin II Receptor Blockers (ARB), impaired renal function, recent medication changes and previous history of allergy or ADR were all associated with an increased risk of experiencing an ADR. Conclusions ADRS associated with antihypertensive medicines were relatively common among older adults admitted to hospital. Increased awareness of those older persons who are most at risk of experiencing an antihypertensive-related ADR in the clinical setting may lead to early detection and minimization of ADR associated harms.

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http://hdl.handle.net/10453/128260