gms | German Medical Science

11. Jahrestagung 2004 der GAA

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

30.09. bis 01.10.2004, Jena

A BMG-funded survey on drug use in elderly patients over 12 months after discharge from hospital: data on drug interactions and drug related events

Meeting Abstract

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  • corresponding author presenting/speaker S. Harder - Institute of Clinical Pharmacology at the pharmazentrum frankfurt, Johann Wolfgang Goethe University Hospital Frankfurt am Main
  • H. Baas - Institute of Clinical Pharmacology at the pharmazentrum frankfurt, Johann Wolfgang Goethe University Hospital Frankfurt am Main
  • H. Prinz - Institute of Clinical Pharmacology at the pharmazentrum frankfurt, Johann Wolfgang Goethe University Hospital Frankfurt am Main
  • K. Ostermann - Institute of Clinical Pharmacology at the pharmazentrum frankfurt, Johann Wolfgang Goethe University Hospital Frankfurt am Main

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie (GAA) e.V.. 11. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie (GAA) e.V.. Jena, 30.09.-01.10.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04gaa25

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gaa2004/04gaa25.shtml

Veröffentlicht: 30. September 2004

© 2004 Harder et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background and Aim

In a group of elderly patients > 65 years requiring chronic medication (N=424), prescriptions after hospital discharge (visit 2) were followed over 1 year. Two home visits took place at 3 (V3) and 12 (V4) months after discharge. The principal findings of this survey have been reported [1]: Deficits in ambulatory prescriptions and poor performance of the medication observed in this survey were in part already employed at discharge from the hospital.

Material and Methods

We analysed the database of this survey on occurence of potential harmful drug-drug interactions (see [2]), interim hospitalisations and medication related events.

Results

A large number of potential drug-drug interactions were seen, but these were obviously without clinical consequences. 6% (V2 and V3) and 7% (V4) of all prescriptions were partner of a potential drug interaction. At discharge, 12% of all patients received a combination of an ACE-inhibitor with a potassium-sparing thiazide and/or potassium supplement, this rate was unchanged in ambulatory follow up. Interactions with aspirin (most often with other NSAID) or phenprocoumon were seen in 2% (V2), 3% (V3) and 5% (V4) of alle patients.

At home visits, only a few patients (4% to 6%) reported (unspecific) side effects of their medication which could not be attributed by them to a certain drug. However, altogether 116 new hospital admissions were recorded in 96 patients, 18 of these admissions were propably or possibly triggered by medication problems, 12 cases due to medication overdose or inappropriate prescription, 6 case due to missing prescriptions. 5 of 43 documented deaths might possibly be caused by a fatal drug event: arrythmia under drug-induced hyperkalaemia (2), hypoglycaemia under high-dose glibenclamide (1), intracerebral hemorrhage under oral anticoagulation (1) and heart failure with tachycardia under high dose theophylline and amitryptiline (1).

Conclusions

Taken altogether, these data are in keeping with previous reports on drug-drug interactions and drug related hospital admissions in comparable patient cohorts (Veehof et al. 1999, Egger et al. 2003).

Conflict of interest: none


References

1.
Harder S, Fischer P, Krause-Schäfer M, Baas H, Prinz H, Helms G, Ostermann K. Medication in elderly patients: a BMG-funded survey addressing changes in prescription, actual drug use, drug knowledge and quality markers of treatment at 3 months and 12 months after discharge from hospital. Germ Med Sci [serial on the Internet]. 2003; Doc 03gaa20. Available from: http://www.egms.de/en/meetings/gaa2003/03gaa20.shtml
2.
Egger SS, Drewe J, Schlienger RG. Potential drug-drug interactions in the medication of medical patients at hospital discharge. Eur J Clin Pharmacol. 2003 Mar;58(11):773-8. Epub 2003 Feb 21.