Iatrogenic risk in elderly patients

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Published Oct 8, 2024
https://doi.org/10.62438/tunismed.v102i10.4970
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Vol. 102 No. 10 (2024): Tunis Med oct 2024

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Zohra Chadli
Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Tunisia
Kmar Kasraoui
Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Tunisia
Ibtissem Hannachi
Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Tunisia
Amel Chaabane
Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Tunisia
Rim Klii
Internal Medicine Department, University Hospital of Monastir, Tunisia
Haifa Ben Romdhane
Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Tunisia
Naceur Boughattas
Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Tunisia
Nadia Ben Fredj
Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Tunisia
Karim Aouam
Department of Pharmacology, University Hospital of Monastir, Faculty of Medicine, University of Monastir, Tunisia

Abstract

Introduction-Aim: The iatrogenic risk in the elderly is a real public health problem due to its frequency and seriousness. Our study aimed to analyze the epidemiological, clinical and chronological aspects of adverse drug reactions occurring in elderly subjects and to identify the incriminated drugs.


Methods: We carried out a retrospective study of all the observations of adverse drug reactions in elderly subjects, notified to the Clinical Pharmacology department of Monastir over a period of 17 years (2004 - 2020). Drug skin tests were performed according to ENDA recommendations and imputability was analyzed using the French method of Bégaud et al. The drugs have been grouped according to the ATC classification.


Results: Among 545 events occurring in elderly subjects, drug responsibility was retained in 209 patients. They were 106 men and 103 women (gender-ratio=1.03). The average age of the patients was 72.3±6 years. Drug hypersensitivity reactions accounted for 75% of all adverse effects. The majority of these reactions were type IV (delayed). The incriminated drugs were: anti-infectives (47%), drugs for the musculoskeletal system (20%), drugs for the cardiovascular system (17%) and drugs for the central nervous system (5%).


Conclusion: Through this study, we noted a predominance of delayed drug hypersensitivity reactions as well as an increased involvement of anti-infectives and allopurinol in the occurrence of adverse effects in the elderly population.

Keywords:

Elderly, Adverse drug reactions, geriatrics, Pharmacoepidemiology

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