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Do older hospital patients recognize adverse drug reactions?
C K Mannesse1, F H Derkx, M A de Ridder
1Department of Geriatric Medicine, University Hospital Rotterdam Dijkzigt, Rotterdam, The Netherlands. c.mannesse@worldonline.nl
Age and Ageing
|February 26, 2000
Summary
Older patients often correctly identify drug side effects. However, they may not recognize severe adverse drug reactions, highlighting the need for careful assessment upon hospital admission.
Area of Science:
- Geriatric Medicine
- Clinical Pharmacology
- Patient Safety
Background:
- Adverse drug reactions (ADRs) are a significant concern in older patients.
- Subjective patient reports of drug side effects are common but their accuracy requires investigation.
Purpose of the Study:
- To determine the relationship between older patients' subjective complaints of drug side effects and the objective presence of ADRs.
- To evaluate the accuracy of patient self-reporting of drug-related side effects.
Main Methods:
- Observational cross-sectional study conducted in five medical wards of a university hospital.
- Inclusion of 106 patients aged 70 and over admitted over a 3-month period.
- Statistical comparison and application of Kramer's algorithm for analysis.
Main Results:
- 39% of patients reported experiencing drug side effects, with higher comorbidity in this group.
- Patient perception of ADRs showed a 79% accuracy rate (true positive/negative).
- Sensitivity for detecting ADRs was 0.70, specificity was 0.85; severe ADRs were unrecognized in 14 out of 21 patients.
Conclusions:
- Older patients' subjective complaints about drug side effects are often accurate and should be elicited upon admission.
- Severe adverse drug reactions pose a challenge for recognition by older patients.
- Clinical vigilance is crucial for identifying severe ADRs in elderly populations.