Study shows older, poorer people at greater risk from adverse drug reactions

A review by academics at Swansea University has found that older, poorer people who are socially distanced from their doctors or pharmacists, suffer more adverse drug reactions than the general population and that systematic monitoring is needed to protect these patients suffering from reactions which could result in over-sedation, falls, or drug-induced Parkinsonism.

The paper, published in the Geriatrics journal, acknowledges that despite modern efforts to move towards “patient-centred medicine”, doctors tend to treat their patients at a distance. The emphasis on prescribing treatment for patients while having limited contact with them, is especially true in relation the treatment of older patients in long-term care facilities. The problem is amplified by the overall lack of regular systematic reviews of the patient meaning opportunities are being missed to identify medication errors and undetected adverse drug reactions.

Professor David Hughes, who led the paper said: “It is very unfortunate that the combination of social distance between doctors and older and often poorer patients, and treatment centring on drugs prescribed without regular patient contact and checks, increases the risks of medication mistakes and adverse drug reactions. I am also very concerned that is a much more common scenario during the pandemic, given that patients in care homes are more likely to be living in lockdown, often without direct contact with their doctors.”

The study recommends the use of the Adverse Drug Reaction Profile as a solution. The Adverse Drug Reaction Profile, is a carer administered systematic checklist that makes the detection of common ADRs easier and provides staff and nurses with information to link signs and symptoms on the checklist to prescription medicines. This multi-disciplinary approach allows home care staff and nurses to link in with prescribers such as doctors and pharmacists, to provide them with personalised patient information and evidence so that prescribers are able to respond quickly to identified problems and adjust prescribing.

Paper co-author, Professor Sue Jordan said: “The profile identifies and documents patients’ signs and symptoms of adverse drug reactions and better monitoring allows professionals to respond with agility. While we realise that the implementation of the adverse drug reactions monitoring system will require changes to the regulatory regime at inspectorate level, it will make for better inter-professional cooperation. Providing carers, nurses and pharmacists with a structured system to monitor patients would democratise relevant medical knowledge and also help address ageism and the socio-economic health divide.”

(Lead Image: Swansea University)