Associations between chronic disease profiles and self-reported adverse drug reactions in community-dwelling older adults: A cross-sectional study.

PURPOSE: This study examined the associations between the types and number of chronic diseases and adverse drug reactions (ADRs) in community-dwelling older adults, aiming to identify high-risk groups and inform nursing strategies for medication safety.

METHODS

This cross-sectional analysis included 4,478 adults aged ≥65 years from the 2021 Korea Health Panel Survey. Thirty-one physician-diagnosed chronic diseases were grouped into 11 categories, and the number of diseases was classified as 0~1, 2, 3, 4, or ≥5. ADRs were operationally defined using a single self-report item asking whether participants had experienced side effects from any medications, including over-the-counter drugs. Multiple logistic regression analyses adjusted for sociodemographic and health-related covariates were conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Arthritis and spinal diseases showed the strongest association with ADRs (OR=2.16, 95% CI=1.44~3.24), followed by depression (OR=2.15, 95% CI=1.22~3.79) and cardio-cerebrovascular diseases (OR=1.86, 95% CI=1.25~2.77). ADR risk increased progressively with multimorbidity: OR=1.87 for two diseases, 2.63 for three, 3.15 for four, and 6.22 for ≥five diseases, compared with 0~1 diseases.

CONCLUSION

ADRs were significantly more likely among older adults with arthritis and spinal diseases, depression, or cardio-cerebrovascular diseases, with risk escalating as multimorbidity increased. Embedding disease type and burden into nursing assessment enables targeted medication review, education, and proactive monitoring. Such nurse-led, collaborative strategies can mitigate drug-related harm and inform policy and training for safe medication use in aging populations.