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Incidence of drug-related problems and adverse drug events in primary care

Page history last edited by Kirsten Holme 13 years, 7 months ago

Below is the editors’ summary of the – primarily – quantitative results emerging from evaluating all the studies.

 

Incidence of drug-related hospital admissions

The meta analyses show an incidence of drug-related hospital admissions of 6-14 %

The incidence of drug-related hospital admissions found in original articles is 4-10 %

The meta analyses show an incidence of hospital admissions purely due to adverse drug reactions of 3-5 %

The incidence found in original articles of hospital admissions due to adverse drug reactions is 2.5-8.0 %

Approximately 2 % of hospital admissions are fatal

Towards 80 % of hospital admissions are severe

Approximately 60 % of hospital admissions are preventable, depending on disease

Adverse drug reactions are the cause of 23-52 % of drug-related hospital admissions

Non-adherence is the cause of 2-11 % of drug-related admissions

Therapy failure is the cause of 2.5-4.5 % of drug-related admissions

Cardiovascular drugs (in particular diuretics), antibiotics, pain-relievers and central nervous system (CNS) drugs are high-risk drugs with regard to drug-related hospital admissions

The risk of drug-related hospital admissions increases with high age and an increased number of drugs. The association to gender is uncertain

The duration of drug-related hospital admissions exceeds normal

The costs of drug-related hospital admissions exceed normal.

 

Incidence of drug-related visits to the emergency department

Studies including a high number of patients show an incidence of drug-related visits to the emergency department of 0.05-0.6 %

Studies including a limited number of patients show an incidence of 10-22 %

Other studies show an incidence of 3-5 %

15-25 % of patients are subsequently admitted to hospital

30-64 % of visits are due to adverse drug reactions and adverse effects

28-58 % of visits are due to non-adherence

Approximately 30 % of visits are due to therapy failure

Cardiovascular drugs, pain-relievers, antibiotics, CNS drugs and hormones are high-risk drugs with regard to drug-related visits to the emergency department

There is no evidence of an association between age and risk

There is evidence that women are at increased risk.

 

Incidence of adverse drug events and drug-related problems in general practice

The area has not been examined sufficiently

The risk of falling is related to the use of CNS drugs, antidepressants, pain-relievers and cardiovascular drugs, and high age

24.5 % of patients who refilled their prescriptions had an adverse drug event

3 studies of medication review in general practice show an incidence of drug-related problems in 43-44 % of patients and with 56 % of the drugs.

 

Incidence of adverse drug events and drug-related problems in nursing homes

None of the evaluated studies assess the incidence of adverse drug events

It is documented that nursing home residents experience many drug-related problems; most frequent are: inappropriate choice of drug, overdosage, interactions, and risk of adverse drug reactions and adverse effects

High-risk drugs with regard to adverse drug events/drug-related problems are antidepressants, sedatives/hypnotics and antibiotics

The risk of adverse drug events increases with the number of drugs.

 

Incidence of drug-related problems identified at the pharmacy

There is evidence that pharmacy staff can identify drug-related problems among users of prescription and OTC medicines

The incidence of drug-related problems is high. During campaigns, problems have been identified in the case of 30-40 % of patients. In Pharmaceutical Care programmes, problems have been identified in 75-100 % of patients

The most frequently identified problems are: inappropriate drug use by the patient, adverse drug reactions and adverse effects, and lack of knowledge of disease and therapy

In an international perspective, it has been documented that pharmacies intervene in 1-4 % of all prescriptions

In Denmark, it has been documented that the pharmacy intervenes in 0.5 % of all new prescriptions, i.e. 200,000 prescriptions annually.

 

Full summary including references at the end of the summary 

 

 

 

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