DIGITAL HEALTH SUPPORTED ADVERSE DRUG REACTION REPORTING AMONG ELDERLY PATIENTS RECEIVING CARDIOVASCULAR

Medications Haripravin P. K.*, Suhail Ahmed J.

ABSTRACT

Background: Elderly patients receiving cardiovascular medications are vulnerable to adverse drug reactions (ADRs) because of ageing-related physiological changes, multimorbidity, polypharmacy, and long-term medication exposure. Conventional ADR reporting may miss mild, delayed, or nonspecific medication-related symptoms, particularly in outpatient settings. Objective: This study assessed whether pharmacist-supported digital follow-up could improve ADR reporting yield and medication adherence among elderly patients receiving cardiovascular medications. Methods: A prospective controlled quasi-experimental study was conducted among 500 elderly outpatients receiving cardiovascular medications at a tertiary care hospital in Erode, Tamil Nadu, India. Participants were allocated into a control group receiving routine care and traditional ADR reporting (n=250) and a digital intervention group receiving pharmacist-supported telephone/WhatsApp-based follow-up (n=250). ADR reporting yield, medication-class-wise ADR reporting, organ-system distribution, Naranjo causality classification, and medication adherence using MARS-10 scores were evaluated. Results: Baseline demographic characteristics, cardiovascular diagnoses, medication utilization pattern, and baseline MARS-10 scores were comparable between groups. The digital intervention group documented 243 ADR reports compared with 180 reports in the control group, representing 63 additional reports and a 35.0% higher ADR reporting yield. The aggregate rate ratio was 1.35 (95% CI: 1.11–1.64; p=0.002). Gastrointestinal and cardiovascular reactions were the most frequently reported ADR categories in both groups. Most ADRs were classified as probable using the Naranjo causality assessment scale. Medication adherence improved in both groups, with a greater increase in the digital intervention group. End-of-study MARS-10 scores were significantly higher in the digital intervention group than in the control group (8.4 ± 1.1 vs 7.2 ± 1.4; p<0.001). Conclusion: Pharmacist-supported telephone/WhatsApp-based digital follow-up improved ADR reporting yield and medication adherence among elderly patients receiving cardiovascular medications. This simple, low-cost approach may support pharmacovigilance and medication-use behaviour in routine outpatient care.

Keywords: Adverse Drug Reaction Reporting; Pharmacovigilance; Medication Adherence; Cardiovascular Agents; Aged; Telemedicine.