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Polypharmacy

Background, Goal and Objectives Polypharmacy PDF
Polypharmacy - weighing up the benefits and harms
Elderly people are at increased risk of drug related problems
Drugs associated with increased risk of adverse drug reactions in elderly people
Common drug interactions in elderly people
Recognising adverse drug reactions
Risk factors for drug related problems in elderly people
A really good recipe for DRP
Drug related harm; terms and definitions
Hospital admissions for adverse drug reactions
Commonly reported adverse drug reactions
References, Bibliography

Hospital admissions for adverse drug reactions

We identified hospital admissions in 2005 for adverse drug reactions in people over 50 years of age by extracting ICD-10 codes and patient demographic data from the Hospital Separation Diagnosis Database. International literature suggests that these data are likely to underestimate the actual number of admissions for adverse drug reactions because of incomplete coding.

Over the year, there were 15,254 admissions for 17,806 adverse drug reactions. There were 146 different adverse drug reactions recorded. Adverse drug reactions increase with age (graph below). Fifty six percent were female. Only 8% of overall admissions for adverse drug reactions were for Māori people although Māori represent approximately 15% of the population. However, in the younger age-bands 50-59, Māori represented a greater proportion of admissions probably due to being on more drugs at a younger age caused by earlier onset of chronic disease.

Hospital admissions for adverse drug reactions increase with age

Admissions graph

Anticoagulants were the most frequently implicated drugs followed by diuretics, opioids, non steroidal anti-inflammatory drugs and beta blockers.

Number of admissions for ADR by drug group
Main drug group Admissions Sub-group Admissions
Cardiovascular
(43.3%)
7711 anticoagulants 1779
diuretics 1552
beta-blockers 1023
ACE inhibitors 810
antiarrhythmics 703
vasodilators 577
calcium channel blockers 434
antihypertensive 288
aspirin 230
α-adrenoceptor blocker 155
lipid-lowering 153
other 7
Nervous system
(17.4%)
3107 opioids 1289
antidepressants 424
antipsychotics 362
anaesthetic 180
benzodiazepines 159
antiepileptics 143
analgesics 121
other 429
Anti-inflammatory
(11.6%)
2074 NSAIDs 1124
corticosteroids 950
Anti-infectives
(10.3%)
1826 penicillin 698
cephalosporin 192
other 936
Oncology agents
(6.4%)
1139 anti-neoplasm 978
immunosuppressant 152
other 9
Alimentary tract
(4.5%)
805 insulin & oral hypoglycaemics 440
other 365
Other
(6.4%)
1144 musculo-skeletal 178
hormone preparations 106
respiratory 81
topical 38
sensory system 25
vaccine 13
other 703
TOTAL 17806

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