Characteristics of Drug-RElated Hospitalizations for Nursing HOme Residents: Cross-Sectional RENHO Study.

IF 3.8 2区医学 Q1 PHARMACOLOGY & PHARMACY

Drug Safety Pub Date : 2025-06-30 DOI:10.1007/s40264-025-01556-3

Alice Lopez, Chiara Alfarano, Marianne Lepetit, Leila Chebane, Nassima Redjimi, Anaïs Couret, Didier Fabre, Virginie Gardette, Driss Berdaï, Maryse Lapeyre-Mestre, Haleh Bagheri

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引用次数: 0

Abstract

Background: Nursing home residents with advancing age are often exposed to polypharmacy, a well-known risk factor for adverse drug reactions (ADRs), which increases the risk of hospitalization. Therefore, we assessed the characteristics of and factors associated with ADR-related emergency department (ED) admissions among nursing home residents.

Methods: We carried out a cross-sectional study using the Toulouse University Hospital discharge database to identify nursing home residents ED admissions from 1 April, 2019 to 31 March, 2020. Information was updated for 2 years after inclusion (re-admissions). Emergency department medical files were analyzed to identify factors associated with these admissions (including demographics, functional dependency level, comorbidities, body mass index, ED admission in the previous 12 previous months, and number of drugs).

Results: We identified 1514 patients (corresponding to 2024 ED admissions), 409 of whom (27.0%) were admitted at least once for an ADR. Thirty-six nursing home residents were re-admitted in 2020 and/or 2021 for ADRs, half of whom were for the same ADR. The most frequent ADRs were falls (114, 24.3%), hemorrhagic events (106, 22.6%), and constipation (47, 10.0%) involving benzodiazepines and Z-drugs (170, 16.0%), antidepressants (125, 11.9%), antithrombotic drugs (110, 10.3%), and opioids (82, 7.7%). About 12% of ADRs were assessed as avoidable. Factors significantly associated with ADR-related ED admissions were the number of drugs (odds ratio 1.09; 95% confidence interval 1.05-1.13), previous ED admissions (odds ratio 3.47; 95% confidence interval 2.46-4.90), and overweight (odds ratio 1.54; confidence interval 1.15-2.06).

Conclusions: Drug-induced iatrogenic disease could lead to ED admission for nursing home residents in approximately one-quarter of cases, 12% of which were assessed as avoidable. A previous history of ED admission and polypharmacy remain key associated factors. The awareness-raising campaigns for health professionals should be strengthened to prevent avoidable drug-induced ADRs.

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疗养院居民药物相关住院的特征：横断面RENHO研究。

背景：高龄养老院居民经常接触多种药物，这是众所周知的药物不良反应（adr）的危险因素，增加了住院的风险。因此，我们评估了疗养院居民中与adr相关的急诊科（ED）入院的特征和相关因素。方法：我们利用图卢兹大学医院出院数据库进行了一项横断面研究，以确定2019年4月1日至2020年3月31日期间养老院居民的急诊科入院情况。信息在纳入后2年内更新（再次入院）。对急诊科医疗档案进行分析，以确定与这些入院相关的因素（包括人口统计学、功能依赖水平、合并症、体重指数、过去12个月的急诊科入院情况和药物数量）。结果：我们确定了1514例患者（对应于2024例ED入院），其中409例（27.0%）因不良反应至少入院一次。36名养老院居民在2020年和/或2021年因ADR再次入院，其中一半是相同的ADR。最常见的不良反应是跌倒（114例，24.3%）、出血性事件（106例，22.6%）和便秘（47例，10.0%），涉及苯二氮卓类药物和z类药物（170例，16.0%）、抗抑郁药（125例，11.9%）、抗血栓药物（110例，10.3%）和阿片类药物（82例，7.7%）。约12%的不良反应被评估为可避免的。与adr相关的ED入院有显著相关的因素是药物数量(优势比1.09；95%可信区间1.05-1.13)，以前的急诊科入院(优势比3.47；95%可信区间2.46-4.90)和超重(优势比1.54；置信区间1.15-2.06)。结论：药物引起的医源性疾病可能导致疗养院居民大约四分之一的急诊科入院，其中12%的病例被评估为可避免的。以前的ED入院史和多种药物仍然是关键的相关因素。应加强卫生专业人员的提高认识运动，以预防可避免的药物引起的不良反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Safety 医学-毒理学

CiteScore

7.60

自引率

7.10%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.