Outcomes of adverse drug events reported with potentially inappropriate medications in older adults, 2004-2017

Background Prescribing of potentially inappropriate medications (PIMs) in adults who are >= 65 years old have been associated with adverse drug events (ADEs). Aim To describe ADEs with PIMs in the older adults based on demographics, ADE severity level, and medication class. Method All ADEs reported to the U.S. Food and Drug Administration Adverse Event Reporting System between 1 January 2004 and 31 December 2017 were reviewed. Data were collected for any ADEs associated with PIMs in adults with ages >= 65 years per the Beers Criteria, including demographics, ADE severity, and ADE date. ADEs were further analysed for any death, hospitalisation, disability, and other serious outcomes associated with PIMs. Data were analysed descriptively. Results The number of reported ADEs increased steadily over the 13-year period. Of the total 68 762 ADEs reported, 80.4% were serious ADEs and more women experienced ADEs (52.0%) than men (46.4%). Age group between 65-74 had a higher number of ADE reports than other groups. Of the 55 302 serious ADEs, 2723 were deaths. The anticoagulants class had the highest percentage of ADEs with death outcomes (57.3%), followed by cardiovascular drugs. An estimated cost to manage the total number of serious ADEs was approximately USD$2 billion for the older adults over the 13-year period. Conclusion ADEs from PIMs occurred frequently among older adults and steadily increased over 13 years. Anticoagulants had the highest proportion of the reported ADEs and most of the ADEs were of serious outcomes including death, disabilities, and hospitalisations. The ADEs potentially incur substantial healthcare costs for this population.