• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (9)  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Statistics and Research Methods  • Less Is More  • Drug Therapy  • Adverse Effects  • Alert me on articles by topic  Social Bookmarking   What's this?

The GerontoNet ADR Risk Score

Graziano Onder, MD, PhD; Mirko Petrovic, MD, PhD; Balamurugan Tangiisuran, MPharm, PhD; Marieke C. Meinardi, MD; Winih P. Markito-Notenboom, MD; Annemie Somers, MPharm; Chakravarthi Rajkumar, MD, PhD; Roberto Bernabei, MD; Tischa J. M. van der Cammen, MD, PhD

Arch Intern Med. 2010;170(13):1142-1148. doi:10.1001/archinternmed.2010.153

Background  The aim of the present study was to develop and validate a method of identifying elderly patients who are at increased risk for an adverse drug reaction (ADR).

Methods  Data from the Gruppo Italiano di Farmacoepidemiologia nell’Anziano (Italian Group of Pharmacoepidemiology in the Elderly) were used to develop an ADR risk score. Variables associated with ADRs were identified by a stepwise logistic regression analysis and used to compute the ADR risk score. The ADR risk score was then validated in a sample of older adults who were admitted to 4 university hospitals in Europe (validation study).

Results  Of 5936 patients (mean [SD] age, 78.0 [7.2] years) in the Gruppo Italiano di Farmacoepidemiologia nell’Anziano sample, 383 (6.5%) experienced an ADR. The number of drugs and a history of an ADR were the strongest predictors of ADRs, followed by heart failure, liver disease, presence of 4 or more conditions, and renal failure. These variables were used to compute the ADR risk score. The area under the receiver operator characteristic curve, which assesses the ability of the risk score to predict ADRs, was 0.71 (95% confidence interval, 0.68-0.73). Overall, 483 patients entered the validation study (mean [SD] age, 80.3 [7.6] years), and 56 (11.6%) experienced an ADR. The area under the receiver operator characteristic curve in this sample was 0.70 (95% confidence interval, 0.63-0.78).

Conclusions  This study proposes a practical and simple method of identifying patients who are at an increased risk of an ADR. This approach may be useful in clinical practice as a tool to identify patients at risk and in research to target a population that can benefit from interventions aimed to reduce drug-related illness.

Author Affiliations: Department of Geriatrics, Policlinico A. Gemelli, Catholic University of the Sacred Heart, Rome, Italy (Drs Onder and Bernabei); Department of Geriatrics and Gerontology (Dr Petrovic) and Hospital Pharmacy (Ms Somers), Ghent University Hospital, Ghent, Belgium; Department of Medicine, Brighton and Sussex Medical School, Brighton, England (Drs Tangiisuran and Rajkumar); and Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands (Drs Meinardi, Markito-Notenboom, and van der Cammen).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

The Easiest Way to Predict Adverse Drug Reactions in Older Persons
Matteo Cesari
Arch Intern Med. 2011;171(1):91-92.
EXTRACT | FULL TEXT  

The Easiest Way to Predict Adverse Drug Reactions in Older Persons—Reply
Graziano Onder, Mirko Petrovic, Chakravarthi Rajkumar, and Tischa J. M. van der Cammen
Arch Intern Med. 2011;171(1):92.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Adverse Drug Responses: An Increasing Threat to the Well-being of Older Patients: Comment on "Development and Validation of a Score to Assess Risk of Adverse Drug Reactions Among In-Hospital Patients 65 Years or Older"
Edward L. Schneider and Vito M. Campese
Arch Intern Med. 2010;170(13):1148-1149.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Polypharmacy in Nursing Home in Europe: Results From the SHELTER Study
Onder et al.
J Gerontol A Biol Sci Med Sci 2012;0:glr233v1-glr233.
ABSTRACT | FULL TEXT  

Pharmacotherapy at the end-of-life
O'Mahony and O'Connor
Age Ageing 2011;40:419-422.
ABSTRACT | FULL TEXT  

Do Geriatric Conditions Increase Risk of Adverse Drug Reactions in Ambulatory Elders? Results From the VA GEM Drug Study
Steinman et al.
J Gerontol A Biol Sci Med Sci 2011;66A:444-451.
ABSTRACT | FULL TEXT  

The Easiest Way to Predict Adverse Drug Reactions in Older Persons
Cesari
Arch Intern Med 2011;171:91-92.
FULL TEXT  

Less Is More!
Journal Watch Dermatology 2010;2010:1-1.
FULL TEXT