Unerwünschte Arzneimittelwirkungen in der Gerontopsychiatrie

Zusammenfassung

Ziel der Studie war es zu überprüfen, ob die Verordnung „potenziell inadäquater Wirkstoffe“ (PIW) mit einem erhöhten Risiko für unerwünschte Arzneimittelwirkungen (UAW) einhergeht.

Methodik 304 stationäre gerontopsychiatrische Patienten wurden in die Studie eingeschlossen. Anhand der klinischen Daten und Verlaufsdokumentationen wurden Hinweise auf UAW identifiziert. Der Kausalzusammenhang der UAW und der verordneten Wirkstoffe wurde von Experten bewertet.

Ergebnisse Vor der stationären Aufnahme erhielten ca. 30 % aller Patienten ≥ 1 PIW, bei Entlassung waren es 22 %. Risikofaktoren für die Verordnung ≥ 1 PIW waren zunehmende Anzahl verordneter Wirkstoffe und Schizophrenie. Protektiv wirkten daher die Faktoren Demenz und zunehmendes Lebensalter. Die Verordnung von ≥ 1 PIW führte zu einem 5-fach erhöhten Risiko für das Auftreten von ≥ 1 UAW; das Risiko für UAW stieg mit der Zahl der PIW. Die Verordnung von ≥ 1 PIW ging mit einem 4-fach erhöhten Risiko für das Auftreten schwerwiegender UAW einher. Bei Einnahme von ≥ 2 PIW war das Risiko hierfür sogar um ein 10-Faches erhöht.

Schlussfolgerungen Die PRISCUS-Liste bildet wesentliche Risiken für das Auftreten von UAW in der Gerontopsychiatrie ab.

Abstract

Objective The purpose of this study was to examine the extent to which “potentially inappropriate drugs” (PID) are associated with an increased risk for adverse drug reactions (ADR).

Methods Data from 304 geriatric psychiatric inpatients was collected. Medical documentation was used to find indications of ADRs. Causal relationship between the ADR and the prescribed drugs was assessed by experts.

Results Almost 30 % of patients received ≥ 1 PID before admission to hospital, in comparison to 22 % at discharge. Increasing number of total prescriptions and the diagnosis of schizophrenia resulted in an increased risk for receiving ≥ 1 PID. Higher age and dementia were protective factors. Patients receiving ≥ 1 PID had a 5-fold increased risk of experiencing ≥ 1 ADR. Risk for an ADR increased with number of PID prescriptions. Patients treated with ≥ 1 PID had a 4-fold increased risk of experiencing severe ADRs. Risk for severe ADRs was 10-fold higher in patients treated with ≥ 2 PIDs.

Conclusion The PRISCUS list predicts significant risk factors for the occurrence of ADRs in the geriatric psychiatric setting.

Schlüsselwörter

potenziell inadäquate Medikation (PIM) - PRISCUS - unerwünschte Arzneimittelwirkung (UAW) - Arzneimitteltherapiesicherheit - Gerontopsychiatrie

Keywords

potentially inappropriate medication (PIM) - PRISCUS - adverse drug reaction (ADR) - drug safety - geriatric psychiatry

^* geteilte Letztautorenschaft

Publication History

Article published online:
27 March 2021

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