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British Medical Bulletin Advance Access published online on June 18, 2007
British Medical Bulletin, doi:10.1093/bmb/ldm016
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Adverse drug events in the elderly

Kathrin M. Cresswell, Bernard Fernando, Brian McKinstry and Aziz Sheikh*

Division of Community Health Sciences, General Practice Section, University of Edinburgh, 20 West Richmond Street, Edinburgh EH8 9DX, UK

* Correspondence to: Aziz Sheikh, Division of Community Health Sciences, General Practice Section, University of Edinburgh, 20 West Richmond Street, Edinburgh EH8 9DX, UK. Tel: 0131 651 4151; Fax: 0131 650 9119; E-mail: aziz.sheikh{at}ed.ac.uk

Background: Increasing recognition of the burden associated with iatrogenic disease has led to international interest into how best to promote patient safety. Within this field, the subject of adverse drug events (ADEs) has received particular attention, this reflecting the known high frequency with which such events occur, particularly in the elderly.

Methods: We conducted a narrative review summarizing epidemiological data on medication-related adverse events in elderly people, considering various known causes of such events and suggesting practical ways in which prescribing can be made safer for high-risk populations.

Results: There is an increasing recognition that a relatively high proportion of ADEs in the elderly may be preventable. Systems issues have been found to play a particularly powerful role in this context, resulting in several promising approaches to address the problem.

Conclusions: Relatively simple system changes have the potential to reduce the burden associated with medication-related adverse events in the elderly.

Keywords: adverse event • elderly • incident reporting • intervention • medicines management • systems approach • taxonomy

Lord, deliver me from the man who never makes a mistake, and also from the man who makes the same mistake twice. (William J. Mayo)

Accepted for publication May 15, 2007.


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