1. Risk assessment of adverse drug reactions in elderly patients with cardiovascular diseases: Study on diagnostic accuracy
- Author
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Ainura T. Sharaeva, Aida A. Zurdinova, and Aida T. Satybaldieva
- Subjects
adverse drug reactions ,polypharmacy ,cardiovascular drugs ,older adults ,gerontonet scale ,diagnostic accuracy ,roc analysis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: The aim of the study was to assess prognostic value and diagnostic accuracy of the universal and adapted GerontoNet ADR risk score in prediction of risk of adverse drugs reactions (ADRs) among hospitalized older adult (≥65 years old) patients with cardiovascular (CV) diseases. Methods: The study design - retrospective observational study on diagnostic accuracy. Medical records of 113 patients over 65 years old with CV diseases were analyzed. Demographic, history, comorbidities, diaries, clinical, laboratory, and instrumental data, prescription sheets were retrieved. To evaluate the risk of ADRs, prescription sheets from the medical histories were analyzed using the "GerontoNet ADR Risk" scale, specialized and validated risk stratification scale "GerontoNet ADR Risk." We used ROC analysis for assessment of diagnostic accuracy of GERONTONET ADR score and calculated sensitivity, specificity, positive and negative predictive values. Results: History of adverse drug reactions ADRs was noted in 2 (1.76%) patients. During hospitalization, ADRs were identified in 26 patients (23%). An increase in transaminase levels above 2 upper limits during treatment was observed in 7 patients (6.19%), confusion, speech slowness, coordination problems, and drowsiness were noted in 9 patients (7.96%), bradycardia occurred in 5 (4.42%), and electrolyte disturbances in 5 (4.42%), and renal dysfunction was noted in 3 (2.6%). GerontoNet ADR score had a significant prognostic value in identification of adverse reactions development (OR- 10.41, 95% CI 3.53-30.75, p < 0.001) and strong diagnostic accuracy (AUC 0 0.88, 95% CI, 0.83-0.89) based on the ROC curve. Sensitivity and specificity analyses of the GerontoNet scale for predicting the risk of ADRs in our study showed that the sensitivity of the scale was 80.77% and the specificity was 71.26%, positive predictive value (PV) of this - 45.65% and negative PV - 92.5% of cases. The accuracy of the scale was 73.45%. Conclusion: The study concluded that the GerontoNet scale demonstrates good sensitivity and specificity and can be used as a tool for identifying patients at high risk of ADRs, allowing timely therapy adjustments to optimize pharmacotherapy and reduce the severity of these reactions. Therefore, broader application of the GerontoNet ADR Risk scale is advisable for older adult patients with CV diseases.
- Published
- 2025
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