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    Adverse drug events resulting from patient errors in older adults.

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    Authors
    Field, Terry S.
    Mazor, Kathleen M.
    Briesacher, Becky A.
    Debellis, Kristin R.
    Gurwitz, Jerry H.
    UMass Chan Affiliations
    Department of Medicine, Division of Geriatric Medicine
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2007-02-01
    Keywords
    Adverse Drug Reaction Reporting Systems
    Aged
    Aged, 80 and over
    Comorbidity
    Drug Therapy
    Female
    Humans
    Male
    Medication Errors
    Pharmaceutical Preparations
    Polypharmacy
    Self Administration
    Health Services Research
    Medicine and Health Sciences
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    Link to Full Text
    http://dx.doi.org/10.1111/j.1532-5415.2007.01047.x
    Abstract
    OBJECTIVES: To characterize the types of patient-related errors that lead to adverse drug events (ADEs) and identify patients at high risk of such errors. DESIGN: A subanalysis within a cohort study of Medicare enrollees. SETTING: A large multispecialty group practice. PARTICIPANTS: Thirty thousand Medicare enrollees followed over a 12-month period. MEASUREMENTS: Primary outcomes were ADEs, defined as injuries due to a medication, and potential ADEs, defined as medication errors with the potential to cause an injury. The subset of these events that were related to patient errors was identified. RESULTS: The majority of patient errors leading to adverse events (n=129) occurred in administering the medication (31.8%), modifying the medication regimen (41.9%), or not following clinical advice about medication use (21.7%). Patient-related errors most often involved hypoglycemic medications (28.7%), cardiovascular medications (21.7%), anticoagulants (18.6%), or diuretics (10.1%). Patients with medication errors did not differ from a comparison group in age or sex but were taking more regularly scheduled medications (compared with 0-2 medications, odds ratio (OR) for 3-4 medications=2.0, 95% confidence interval (CI)=0.9-4.2; OR for 5-6 medications=3.1, 95% CI=1.5-7.0; OR for >or=7 medications=3.3, 95% CI=1.5-7.0). The strongest association was with the Charlson Comorbidity Index (compared with a score of 0, OR for a score of 1-2=3.8, 95% CI=2.1-7.0; OR for a score of 3-4=8.6, 95% CI=4.3-17.0; OR for a score of >or=5=15.0, 95% CI=6.5-34.5). CONCLUSION: The medication regimens of older adults present a range of difficulties with the potential for harm. Strategies are needed that specifically address the management of complex drug regimens.
    Source
    J Am Geriatr Soc. 2007 Feb;55(2):271-6.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37110
    PubMed ID
    17302666; 17302666
    Related Resources
    Link to article in PubMed
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    UMass Chan Faculty and Researcher Publications

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