Análisis retrospectivo de los acontecimientos adversos por medicamentos en pacientes ancianos en un centro de salud de atención primaria

Abstract

Objective. To describe the adverse drug events (ADEs) reported by doctors of a primary health care centre in the patient's medical record. Design. A retrospective, descriptive study. Setting. Burriana Health Centre (Castellón), Spain. Participants. All patients over 75 with a clinical history held on paper at the health centre, ie non-institutionalized patients seen on an out-patient basis, were checked. Measurements. A total of 2044 paper-based medical records were analysed, in which 832 histories describing 1893 ADEs (90.4% unforeseen and 9.6% preventable) were found. This means that 41% of the patients experienced one or more adverse events, with an average of 2.28 ADEs per patient. Results. Most ADEs (85.3%) were light, but 6% were classified as serious, with high digestive haemorrhage caused by NSAIDs standing out as the most common serious problem (37.3%). The pharmacotherapeutic groups most involved in ADEs were cardiovascular therapy (29.4%), anti-infectious drugs (21.2%) and nervous system drugs (20.1%). Seventeen cases of intoxication were detected (0.9% total ADEs), with digoxin responsible for 67% of the serious intoxications. It was observed that ADEs occur with statistical significance most frequently in women (OR, 1.73; 95% CI, 1.42-2.10). After an age-stratified analysis, it was concluded that the only sub-group where the increase in risk was not significant was the group of people over 85 years old. Conclusions. ADEs create a serious public health problem, with negative effects on patients. Although most ADEs are unforeseen (90.4%), it is still worrying that 9.6% of the ADEs identified are preventable.