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Vol.5 , No. 1, Publication Date: Mar. 10, 2018, Page: 7-14
 in elderly patients is a key focus of actual pharmacotherapy. Approaches to improve safety of pharmacotherapy in the elderly have been developed, amongst others the GerontoNet ADR risk scale. We assessed the applicability of this scale in the psychiatric setting. Hospitalized patients ≥65 years for whom blood-level measurement of a psychotropic drug were requested were included in the study. The diagnostic accuracy of the score in predicting moderate to severe ADRs in these patients was evaluated by receiver operating characteristics (ROC) analysis. In total, 79 patients (65.8% female) with a mean age of 73.5±5.4 years could be included in the study. Patients received by mean 8.8±3.9 drugs. Mean GerontoNet ADR risk score was 3.7±2.3 (range 0-7). A threshold value between 4 and 5 was computed to identify patients who are at high risk for moderate to severe ADRs. For this value predictive validity exhibited 71% sensitivity and 84% specificity (AUC: 0.808, 0.708-0.908, 95% CI). The score seems to be a good predictor for psychiatric patients who are at increased risk for an ADR. However, this tool is mainly based on the number of drugs ingested by the patient and does not consider several further risk factors associated with ADRs, as too high drug serum concentrations. We suggest to replace some variables in the GerontoNet ADR risk score for the psychiatric setting.&picture=http://www.aascit.org/aascit/decorators/img/journal/906.jpg)
| [1] | Gudrun Hefner, Psychiatric Hospital, Vitos Klinik Hochtaunus, Friedrichsdorf, Germany. |
| [2] | Martina Hahn, Psychiatric Hospital, Vitos Klinik Eichberg, Eltville, Germany. |
| [3] | Sibylle C. Roll, Psychiatric Hospital, Vitos Klinik Eichberg, Eltville, Germany. |
| [4] | Ansgar Klimke, Psychiatric Hospital, Vitos Klinik Hochtaunus, Friedrichsdorf, Germany. |
| [5] | Christoph Hiemke, Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany. |
Preventing predictable adverse drug reactions (ADRs) in elderly patients is a key focus of actual pharmacotherapy. Approaches to improve safety of pharmacotherapy in the elderly have been developed, amongst others the GerontoNet ADR risk scale. We assessed the applicability of this scale in the psychiatric setting. Hospitalized patients ≥65 years for whom blood-level measurement of a psychotropic drug were requested were included in the study. The diagnostic accuracy of the score in predicting moderate to severe ADRs in these patients was evaluated by receiver operating characteristics (ROC) analysis. In total, 79 patients (65.8% female) with a mean age of 73.5±5.4 years could be included in the study. Patients received by mean 8.8±3.9 drugs. Mean GerontoNet ADR risk score was 3.7±2.3 (range 0-7). A threshold value between 4 and 5 was computed to identify patients who are at high risk for moderate to severe ADRs. For this value predictive validity exhibited 71% sensitivity and 84% specificity (AUC: 0.808, 0.708-0.908, 95% CI). The score seems to be a good predictor for psychiatric patients who are at increased risk for an ADR. However, this tool is mainly based on the number of drugs ingested by the patient and does not consider several further risk factors associated with ADRs, as too high drug serum concentrations. We suggest to replace some variables in the GerontoNet ADR risk score for the psychiatric setting.
Keywords
Therapeutic Drug Monitoring, Adverse Drug Reactions, Risk Score, Elderly Patients, Psychiatry
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