The Prevention of Adverse Drug Reactions in Older Subjects

Antonio      Cherubini; Carmelinda      Ruggiero; Beatrice      Gasperini; Giuseppina      Dell'Aquila; Maria      Grazia Cupido; Elena      Zampi; Elisa      Zengarini; Hao Nguyen      Nguyen; Rocco      Serra; Andrea      Corsonello; Fabrizia      Lattanzio

Abstract

Adverse drug reactions (ADRs) are a public health problem in older subjects, being responsible for a significant morbidity, disability and mortality. Older subjects are more susceptible to develop ADRs mainly due to polypharmacy, multimorbidity and inappropriate prescribing. The prevention of these drug related negative events represents an important aim for physicians treating older patients. Several strategies could potentially be employed, including state of the art education of medical students and physicians concerning principles of geriatric medicine and appropriate prescription in older subjects, reduction of inappropriate drug use by means of computerized decision support systems, pharmacist involvement and comprehensive geriatric assessment, and finally the identification of at risk older patients. However, there is currently a lack of scientific evidence demonstrating that these strategies can achieve a reduction in ADRs and therefore future intervention studies should be performed to evaluate the best intervention to decrease the burden of drug related problems in the older population.

Keywords: Adverse drug reaction, comprehensive geriatric assessment, inappropriate prescription, multimorbidity, older subject, polypharmacy, prevention, prophylaxis, overdose, accentuation