Title: Adverse Drug Reactions (ADRs) and preventability, in elderly DR TB patients admitted at Tuberculosis Hospital in Mumbai, India
Authors: Dr Rajendra Nanavare, Dr Daksha Shah, Dr Jagdish Keni, Dr Nilima Kshirsagar
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.172
Abstract
Background: Tuberculosis is a global health problem and emergence of MDR TB is a major threat to tuberculosis care and control. Treatment of MDR TB is challenging due to toxicity of second-line drugs used. Elderly population has several risk factors that can increase their susceptibility to ADR.
Methods: A retrospective analysis of records of MDR TB patients admitted, to Group of T.B. Hospital, a specialized TB hospital in Mumbai, India, during January 2016 – December 2016, was carried out to evaluate ADRs in patients ≥ 60 years of age and compare it with patients < 60 years. ADRs were assessed for system organ classification, seriousness, severity causality, related suspected drugs, preventability using standard methods, and for possible risk factors.
Results: Out of 732 patients admitted, 33 were ≥ 60 years, 99 (three times) patients < 60 years were randomly identified from the remaining 699 of which 91 with required records were included in the analysis. Patients ≥ 60 years had significantly greater incidence of ADRs compared to<60 years age group. ADRs like vomiting, giddiness, otovestibular toxicity (tinnitus and vertigo) and hearing loss were significantly more in patient ≥ 60 years. Patients ≥ 60 years and with diabetes mellitus had significantly more ADRs as compared to patients < 60 years and with DM. ADRs were found to be possibly preventable by proper preventive measures and management as per guidelines.
Conclusion: Elderly population is increasing worldwide and is vulnerable to more ADRs due to comorbidities, pharmacokinetic, pharmacodynamics changes and social factors. Recognition of this vulnerability, emphasis on careful history, counselling and monitoring will help prevent ADRs and better manage elderly DR TB patients.
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