TY  - JOUR
PY  - 2022//
TI  - Drug-related hospital admissions in older adults: comparison of the Naranjo algorithm and an adjusted version of the Kramer algorithm
JO  - European geriatric medicine
A1  - Mertens, Beatrijs
A1  - Hias, Julie
A1  - Hellemans, Laura
A1  - Walgraeve, Karolien
A1  - Spriet, Isabel
A1  - Tournoy, Jos
A1  - Van der Linden, Lorenz Roger
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - PURPOSE: Drug-related admissions (DRAs) are an important cause of preventable harm in older adults. Multiple algorithms exist to assess causality of adverse drug reactions, including the Naranjo algorithm and an adjusted version of the Kramer algorithm. The performance of these tools in assessing DRA causality has not been robustly shown. This study aimed to evaluate the ability of the adjusted Kramer algorithm to adjudicate DRA causality in geriatric inpatients. <br><br>METHODS: DRAs were assessed in a convenience sample of patients admitted to the acute geriatric wards of an academic hospital. DRAs were identified by expert consensus and causality was evaluated using the Naranjo and the adjusted Kramer algorithms. Positive agreement with expert consensus was calculated for both algorithms. A multivariable logistic regression analysis was performed to explore determinants for a DRA. <br><br>RESULTS: A total of 218 geriatric inpatients was included of whom 65 (29.8%) experienced a DRA. Positive agreement was 72.3% (95% confidence interval (CI), 59.6-82.3%) and 100% (95% CI, 93.0-100%) for the Naranjo and the adjusted Kramer algorithm, respectively. Diuretics were the main culprits and most DRAs were attributed to a fall (n = 18; 27.7%). A fall-related principal diagnosis was independently associated with a DRA (odds ratio 20.11; 95% CI, 5.60-72.24). <br><br>CONCLUSION: The adjusted Kramer algorithm demonstrated a higher positive agreement with expert consensus in assessing DRA causality in geriatric inpatients compared to the Naranjo algorithm. Our results further support implementation of the adjusted Kramer algorithm as part of a standardized DRA assessment in older adults.<p />  <p>Language: en</p>
LA  - en
SN  - 1878-7649
UR  - http://dx.doi.org/10.1007/s41999-022-00623-7
ID  - ref1
ER  -