Do older hospital patients recognize adverse drug reactions?

Objective: to establish the relationship between subjective complaints of s ide effects of drugs and the objective presence of adverse drug reactions i n older patients. Design: observational cross-sectional study. Setting: five medical wards at the University Hospital Rotterdam Dijkzigt. Subjects: patients aged 70 and over admitted to the general medical wards o ver a S-month period, Methods: statistical comparison and Kramer's algorithm. Results: of 106 patients, 102 used medication, and 93 of these were able to report whether they believed they were experiencing drug side effects. Thi rty-six [39% (95% confidence interval 28.8-48.6)] believed that they were e xperiencing side effects and the number of diagnoses per patient and the pr oportion of patients with chronic obstructive pulmonary disease was higher in these 36 'complainers' than in the group of the 'non-complainers'. We fo und a correct opinion (true positive and negative) about the objective pres ence or absence of mild or severe adverse drug reactions in 79% (95% confid ence interval 70.2-86.8). Asking the patient about side effects of drugs ha d a sensitivity of 0.70 and a specificity of 0.85 patients. The severe adve rse drug reactions in 21 patients were not recognized by 14 of them. Conclusion: at hospital admission, older patients should be asked about dru g side effects because they are often correct in recognizing them. However, severe adverse drug reactions are not easily recognized.