Get access

Risk Factors for Adverse Drug Events in Older Adults with Mobility Limitations in the Community Setting

Authors

  • Elizabeth Chrischilles PhD,

    1. From the *Department of Epidemiology, College of Public Health, Health Effectiveness Research Center, and College of Pharmacy, University of Iowa, Iowa City, Iowa.
    Search for more papers by this author
  • Linda Rubenstein PhD,

    1. From the *Department of Epidemiology, College of Public Health, Health Effectiveness Research Center, and College of Pharmacy, University of Iowa, Iowa City, Iowa.
    Search for more papers by this author
  • Rachel Van Gilder PhD,

    1. From the *Department of Epidemiology, College of Public Health, Health Effectiveness Research Center, and College of Pharmacy, University of Iowa, Iowa City, Iowa.
    Search for more papers by this author
  • Margaret Voelker PhD,

    1. From the *Department of Epidemiology, College of Public Health, Health Effectiveness Research Center, and College of Pharmacy, University of Iowa, Iowa City, Iowa.
    Search for more papers by this author
  • Kara Wright MS,

    1. From the *Department of Epidemiology, College of Public Health, Health Effectiveness Research Center, and College of Pharmacy, University of Iowa, Iowa City, Iowa.
    Search for more papers by this author
  • Robert Wallace MD, MPH

    1. From the *Department of Epidemiology, College of Public Health, Health Effectiveness Research Center, and College of Pharmacy, University of Iowa, Iowa City, Iowa.
    Search for more papers by this author

Address correspondence to Elizabeth Chrischilles, PhD, Department of Epidemiology, College of Public Health, The University of Iowa, 200 Hawkins Drive, C21-J-GH, Iowa City, IA 52242. E-mail: e-chrischilles@uiowa.edu

Abstract

OBJECTIVES: To investigate risk factors for self-reported adverse drug events (ADEs) in a cohort of annually surveyed Iowa Medicare beneficiaries with mobility limitations.

DESIGN: Prospective cohort study with baseline and two annual follow-up questionnaires.

SETTING: Population-based sample of Iowa Medicare beneficiaries with mobility limitations.

PARTICIPANTS: Members of the cohort with complete follow-up questionnaires and prescription dispensing data (N=689).

MEASUREMENTS: The questionnaires asked about self-reported ADEs in the previous 12 months, sociodemographic data, smoking, alcohol use, number of mobility limitations, and history of chronic disease. Pharmacy dispensing records were the source of number and classes of prescription drug use. Linked Medicare claims provided additional comorbidity data.

RESULTS: Of the 689 subjects, 151 (21.9%) reported an ADE, 83% of which resulted in physician contact and 56% of which resulted in discontinuing the medication. Number of different medications dispensed during the prior year was an independent predictor of a self-reported ADE. Neither age, extent of mobility limitation, nor number of chronic conditions was independently associated with reporting an ADE.

CONCLUSION: Excess ADE risk observed with increasing mobility limitations is mediated through greater medication use.

Ancillary