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Geriatrics on beers criteria medications at risk of adverse drug events using real-world dataopen access

Authors
Shin, HyunahKim, NanyeongCha, JaehunKim, Grace JuyunKim, Ju HanKim, Jong-YeupLee, Suehyun
Issue Date
Oct-2021
Publisher
ELSEVIER IRELAND LTD
Keywords
Adverse drug events (ADEs); Beers criteria; KAERS; FAERS
Citation
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS, v.154
Journal Title
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
Volume
154
URI
https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/88130
DOI
10.1016/j.ijmedinf.2021.104542
ISSN
1386-5056
Abstract
Objectives: The established Beers Criteria consider side effects and safety concerns when prescribing drugs to the elderly. As the criteria suggest that attention should be paid toward prescriptions rather than prescription prohibition lists, these Beers Criteria medications (BCMs) are used appropriately under unavoidable circumstances. Methods: Patients aged > 65 years and with an experience of being prescribed inappropriate medications at Konyang University Hospital, South Korea, were selected. We analyzed data from the Korea Adverse Event Reporting System (KAERS) and the Food and Drug Administration Adverse Event Reporting System (FAERS) of the United States to identify medication-induced adverse drug events (ADEs). The actual incidence was predicted by multiplying the incidence and number of BCMs prescribed to the patients. The proportional reporting ratio (PRR) and reporting odds ratio (ROR) were calculated using KAERS and FAERS data. Results: We predicted that the incidence of ADEs would be higher for metoclopramide, chlorpheniramine, and amitriptyline in patients using medications for more than 1 day and metoclopramide, chlorpheniramine, and ketoprofen in patients using medications only for 1 day. Among the ADEs reported to KAERS and FAERS, significant ROR and PRR values were noted for clonazepam (drowsiness), nortriptyline (sleepiness), and zolpidem (amnesia, somnambulism, agitation, dependence, nightmare, and dysgeusia). Conclusion: This study highlighted the actual status of BCM prescriptions in clinical institutions and predicted the incidence of ADEs. We concluded that greater care must be taken while prescribing BCMs to the elderly and indicators, such as PRR and ROR should be monitored regularly.
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