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Free Content Which drugs cause preventable admissions to hospital? A systematic review

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Previous systematic reviews have found that drug-related morbidity accounts for 4.3% of preventable hospital admissions. None, however, has identified the drugs most commonly responsible for preventable hospital admissions. The aims of this study were to estimate the percentage of preventable drug-related hospital admissions, the most common drug causes of preventable hospital admissions and the most common underlying causes of preventable drug-related admissions. Methods

Bibliographic databases and reference lists from eligible articles and study authors were the sources for data. Seventeen prospective observational studies reporting the proportion of preventable drug-related hospital admissions, causative drugs and/or the underlying causes of hospital admissions were selected. Included studies used multiple reviewers and/or explicit criteria to assess causality and preventability of hospital admissions. Two investigators abstracted data from all included studies using a purpose-made data extraction form. Results

From 13 papers the median percentage of preventable drug-related admissions to hospital was 3.7% (range 1.4–15.4). From nine papers the majority (51%) of preventable drug-related admissions involved either antiplatelets (16%), diuretics (16%), nonsteroidal anti-inflammatory drugs (11%) or anticoagulants (8%). From five studies the median proportion of preventable drug-related admissions associated with prescribing problems was 30.6% (range 11.1–41.8), with adherence problems 33.3% (range 20.9–41.7) and with monitoring problems 22.2% (range 0–31.3). Conclusions

Four groups of drugs account for more than 50% of the drug groups associated with preventable drug-related hospital admissions. Concentrating interventions on these drug groups could reduce appreciably the number of preventable drug-related admissions to hospital from primary care.

Keywords: adverse effects; drug safety; drug therapy; drug toxicity; medication errors; systematic review

Document Type: Research Article


Affiliations: 1: Nottingham Primary Care Research Partnership, Broxtowe & Hucknall PCT, Hucknall Health Centre and 2: Radboud University, Nijmegen, the Netherlands, 3: Primary Care, University of Nottingham at Derby Graduate Entry Medical School, Derby and 4: Division of Primary Care, University of Nottingham, Nottingham, UK, 5: Clinical Pharmacology and Consultant Physician, University of Liverpool, Liverpool, UK

Publication date: February 1, 2007

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