Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models

Jennifer M Stevenson,1,2 Josceline L Williams,1,2 Thomas G Burnham,2 A Toby Prevost,3 Rebekah Schiff,4 S David Erskine,2 J Graham Davies1 1Institute of Pharmaceutical Sciences, King’s College London, London, UK; 2Pharmacy Department, St Thomas’ Hospital, Guy’s and St T...

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Autores principales:	Stevenson JM, Williams JL, Burnham TG, Prevost AT, Schiff R, Erskine SD, Davies JG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Adverse Drug Reactions ADR Older Risk Prediction Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/3fc2ec0b4c9149ae8b13d4e92a8949ff
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spelling	oai:doaj.org-article:3fc2ec0b4c9149ae8b13d4e92a8949ff2021-12-02T02:52:40ZPredicting adverse drug reactions in older adults; a systematic review of the risk prediction models1178-1998https://doaj.org/article/3fc2ec0b4c9149ae8b13d4e92a8949ff2014-09-01T00:00:00Zhttps://www.dovepress.com/predicting-adverse-drug-reactions-in-older-adults-a-systematic-review--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Jennifer M Stevenson,1,2 Josceline L Williams,1,2 Thomas G Burnham,2 A Toby Prevost,3 Rebekah Schiff,4 S David Erskine,2 J Graham Davies1 1Institute of Pharmaceutical Sciences, King’s College London, London, UK; 2Pharmacy Department, St Thomas’ Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; 3Department of Primary Care and Public Health Sciences, King’s College London, London, UK; 4Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust, London, UK Abstract: Adverse drug reaction (ADR) risk-prediction models for use in older adults have been developed, but it is not clear if they are suitable for use in clinical practice. This systematic review aimed to identify and investigate the quality of validated ADR risk-prediction models for use in older adults. Standard computerized databases, the gray literature, bibliographies, and citations were searched (2012) to identify relevant peer-reviewed studies. Studies that developed and validated an ADR prediction model for use in patients over 65 years old, using a multivariable approach in the design and analysis, were included. Data were extracted and their quality assessed by independent reviewers using a standard approach. Of the 13,423 titles identified, only 549 were associated with adverse outcomes of medicines use. Four met the inclusion criteria. All were conducted in inpatient cohorts in Western Europe. None of the models satisfied the four key stages in the creation of a quality risk prediction model; development and validation were completed, but impact and implementation were not assessed. Model performance was modest; area under the receiver operator curve ranged from 0.623 to 0.73. Study quality was difficult to assess due to poor reporting, but inappropriate methods were apparent. Further work needs to be conducted concerning the existing models to enable the development of a robust ADR risk-prediction model that is externally validated, with practical design and good performance. Only then can implementation and impact be assessed with the aim of generating a model of high enough quality to be considered for use in clinical care to prioritize older people at high risk of suffering an ADR. Keyword: aged, stratified care, prognosis, medication-related harmStevenson JMWilliams JLBurnham TGPrevost ATSchiff RErskine SDDavies JGDove Medical PressarticleAdverse Drug ReactionsADROlderRisk PredictionGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 1581-1593 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Adverse Drug Reactions ADR Older Risk Prediction Geriatrics RC952-954.6
spellingShingle	Adverse Drug Reactions ADR Older Risk Prediction Geriatrics RC952-954.6 Stevenson JM Williams JL Burnham TG Prevost AT Schiff R Erskine SD Davies JG Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
description	Jennifer M Stevenson,1,2 Josceline L Williams,1,2 Thomas G Burnham,2 A Toby Prevost,3 Rebekah Schiff,4 S David Erskine,2 J Graham Davies1 1Institute of Pharmaceutical Sciences, King’s College London, London, UK; 2Pharmacy Department, St Thomas’ Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; 3Department of Primary Care and Public Health Sciences, King’s College London, London, UK; 4Department of Ageing and Health, Guy’s and St Thomas’ NHS Foundation Trust, London, UK Abstract: Adverse drug reaction (ADR) risk-prediction models for use in older adults have been developed, but it is not clear if they are suitable for use in clinical practice. This systematic review aimed to identify and investigate the quality of validated ADR risk-prediction models for use in older adults. Standard computerized databases, the gray literature, bibliographies, and citations were searched (2012) to identify relevant peer-reviewed studies. Studies that developed and validated an ADR prediction model for use in patients over 65 years old, using a multivariable approach in the design and analysis, were included. Data were extracted and their quality assessed by independent reviewers using a standard approach. Of the 13,423 titles identified, only 549 were associated with adverse outcomes of medicines use. Four met the inclusion criteria. All were conducted in inpatient cohorts in Western Europe. None of the models satisfied the four key stages in the creation of a quality risk prediction model; development and validation were completed, but impact and implementation were not assessed. Model performance was modest; area under the receiver operator curve ranged from 0.623 to 0.73. Study quality was difficult to assess due to poor reporting, but inappropriate methods were apparent. Further work needs to be conducted concerning the existing models to enable the development of a robust ADR risk-prediction model that is externally validated, with practical design and good performance. Only then can implementation and impact be assessed with the aim of generating a model of high enough quality to be considered for use in clinical care to prioritize older people at high risk of suffering an ADR. Keyword: aged, stratified care, prognosis, medication-related harm
format	article
author	Stevenson JM Williams JL Burnham TG Prevost AT Schiff R Erskine SD Davies JG
author_facet	Stevenson JM Williams JL Burnham TG Prevost AT Schiff R Erskine SD Davies JG
author_sort	Stevenson JM
title	Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_short	Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_full	Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_fullStr	Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_full_unstemmed	Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
title_sort	predicting adverse drug reactions in older adults; a systematic review of the risk prediction models
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/3fc2ec0b4c9149ae8b13d4e92a8949ff
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Predicting adverse drug reactions in older adults; a systematic review of the risk prediction models

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