Background: It has been claimed that the risk of adverse drug reactions inc
reases with age. However, only limited data exist for disease-group specifi
c risks and none for patients with liver and gastrointestinal diseases.
Aims: To determine the incidence and characteristics of adverse drug reacti
ons and the physicians' awareness of adverse drug reactions.
Methods: During a 7-month period, a prospective survey of 532 male patients
(158 aged 65 years or older; 30%) was conducted on a hepatogastroenterolog
ical ward of a tertiary-care university hospital, using intensive bedside a
nd computer-assisted drug surveillance methods.
Results: No difference was found in the overall rate of adverse drug reacti
ons between older and younger patients (25.9% vs. 24.2%) during 6213 treatm
ent days. However, a significantly higher risk for developing adverse drug
reactions could be shown for the elderly with biliary tract diseases (P < 0
.01). Independently of age, patients suffering from gastric ulcers, acute e
pisodes of pancreatitis, cholangitis or inflammatory bowel diseases were at
high risk of adverse drug reactions. Adverse drug reaction-associated mort
ality was encountered in four elderly and none of the younger patients. Sec
ondary pharmacological effects and drug toxicity were the main types of adv
erse drug reactions for both age groups. Although 75.3% of the adverse drug
reactions were predictable, only 37.5% of all adverse drug reactions were
recognized by the staff physicians.
conclusion: In hepatogastroenterological patients, advancing age was not as
sociated with an overall increased risk of adverse drug reactions except fo
r patients with biliary tract diseases. In the elderly, adverse drug reacti
ons were more severe and carried higher mortality. Guidelines and education
al programs should be developed to increase the awareness of adverse drug r
eactions and their prevention, especially in high risk patients and, thus,
to improve patient outcomes.