Background: Adverse or unintended responses to drugs are a significant contributor to global morbidity and mortality, often resulting from allergic reactions, overdosing, or drug-drug interactions. Serious repercussions could result from these instances, particularly for vulnerable populations like the elderly and those with chronic illnesses. This study looked at mortality trends and demographic variations associated with adverse events to drugs intended for therapeutic use from 1999 to 2020.
Methods: Analysis of Therapeutic Drugs Adverse Effects-related deaths in adults (≥25 years) in the U.S. from 1999-2020 was conducted using death certificate data from the CDC WONDER database, utilizing the ICD-10 code Y40-Y59. Age-adjusted mortality rates (AAMR) per 1,000,000 population were extracted, and trends were analyzed using Joinpoint regression to calculate the Average Annual Percent Change (AAPC) with a p-value for statistical significance. Data were stratified using year, gender, race/ethnicity, and geographical regions.
Results: Between 1999 and 2020, Therapeutic Drugs Adverse Effects caused 116,468 deaths among U.S. older adults aged ≥25 years. Most deaths occurred in medical facilities (79.2%) and at decedents homes (10.43%). The overall AAMR for Therapeutic Drugs Adverse Effects-related deaths decreased from 28.96 in 1999 to 23.87 in 2020, with an AAPC of 0.89* (p < 0.000001). Men showed higher AAMRs than women (27.97 vs. 21.94), with a more pronounced increase in men (AAPC: 1.28*, p < 0.000001) compared to women (AAPC: 0.598*, p = 0.019). Racial disparities were significant, with American Indians or Alaska Natives having the highest AAMR (29.15), followed by Whites (25.91), Black individuals (22.88), Hispanics (15.49), and Asians or Pacific Islanders (14.29). The decline in AAMR throughout the study was most pronounced in Hispanics (AAPC:3.89*, p < 0.000001). Geographically, Vermont had the highest AAMR (59.76), and Massachusetts had the lowest (15.16). The Western U.S. had the highest regional AAMR (28.19), followed by the Midwest (26.89), South (23.5), and Northeast (19.62). Nonmetropolitan areas had higher AAMRs than metropolitan areas, though both saw significant declines from 1999 to 2020 (Metropolitan: AAPC: 1.02*, p < 0.000001; Nonmetropolitan: AAPC: 0.43, p =0.12).
Conclusions: Mortality related to adverse drug responses has shown a downward trend over the past two decades. The Western U.S. showed the most significant regional increase in mortality, with higher rates among men, American Indians, and nonmetropolitan areas. According to these findings, improved prescribing procedures, increased pharmacovigilance, and focused interventions for high-risk groups are all necessary.
