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Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: closed (15 December 2022) | Viewed by 32786

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Special Issue Editor

Dr. Renke Maas

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Guest Editor

Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
Interests: clinical pharmacology; medication safety; adverse drug reactions; cardiovascular risk factors

Special Issue Information

Dear Colleagues,

Adverse drug reactions (ADRs) are a common cause of morbidity and mortality. Not all, but many ADRs are considered to be preventable, especially those related to medication errors and inadequate medication. Multimorbidity and polypharmacy in aging populations do not only increase the risk of medication errors and ADR, but also complicate their detection. ADR are (too) frequently not recognized as such, and are often inadequately treated with additional drugs as a new “disease”. The detection and prevention of ADR requires complete and up to date information regarding the patient’s medication and clinical conditions, as well as adequate information regarding the effects and correct use of drugs. IT-based solutions, such as automated medication checks, may aid physicians and pharmacists in identifying medication-related problems and patients at risk of ADRs. However, their use and acceptance are often limited because of issues such as over-alerting and insufficient or incompatible coding of patient and medication data. Closer interdisciplinary cooperation of physicians, pharmacists, and specialists in medical informatics may lead to new innovative methods for the identification and prevention of medication errors and adverse drug reactions.

For this Special Issue we invite authors to submit original works and state of the art reviews on key aspects of medication safety, with a focus on the identification and prevention of medication-related problems.

The Issue is open for submissions from all sections of JCM falling under this topic.

With regard to review topics, please inquire in advance with the guest editor to prevent duplications.

I look forward to and welcome your participation in this Special Issue.

Dr. Renke Maas
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

Adverse drug reaction (ADR)
Adverse drug event (ADE)
Drug interactions
Health information technology
Medical informatics
Medication error
Medication review
Medication safety
Polypharmacy
Pharmacoepidemiology
Pharmacogenomics
Potentially inadequate medication (PIM)

Published Papers (13 papers)

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19 pages, 2120 KiB

Open AccessArticle

Which Adverse Events and Which Drugs Are Implicated in Drug-Related Hospital Admissions? A Systematic Review and Meta-Analysis

by Annette Haerdtlein, Elisabeth Debold, Marietta Rottenkolber, Anna Maria Boehmer, Yvonne Marina Pudritz, Faiza Shahid, Jochen Gensichen and Tobias Dreischulte

J. Clin. Med. 2023, 12(4), 1320; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12041320 - 7 Feb 2023

Cited by 4 | Viewed by 3004

Abstract

Adverse drug events (ADEs) and adverse drug reactions (ADRs) are leading causes of iatrogenic injury, which can result in emergency department (ED) visits or admissions to inpatient wards. The aim of this systematic review and meta-analysis was to provide up-to-date estimates of the prevalence of (preventable) drug-related ED visits and hospital admissions, as well as the type and prevalence of implicated ADRs/ADEs and drugs. A literature search of studies published between January 2012 and December 2021 was performed in PubMed, Medline, EMBASE, Cochrane Library, and Web of Science. Retrospective and prospective observational studies investigating acute admissions to EDs or inpatient wards due to ADRs or ADEs in the general population were included. Meta-analyses of prevalence rates were conducted using generalized linear mixed models (GLMM) with the random-effect method. Seventeen studies reporting ADRs and/or ADEs were eligible for inclusion. The prevalence rates of ADR- and ADE-related admissions to EDs or inpatient wards were estimated at 8.3% ([95% CI, 6.4–10.7%]) and 13.9% ([95% CI, 8.1–22.8%]), respectively, of which almost half (ADRs: 44.7% [95% CI: 28.1; 62.4]) and more than two thirds (ADEs: 71.0% [95% CI, 65.9–75.6%]) had been classified as at least possibly preventable. The ADR categories most frequently implicated in ADR-related admissions were gastrointestinal disorders, electrolyte disturbances, bleeding events, and renal and urinary disorders. Nervous system drugs were found to be the most commonly implicated drug groups, followed by cardiovascular and antithrombotic agents. Our findings demonstrate that ADR-related admissions to EDs and inpatient wards still represent a major and often preventable health care problem. In comparison to previous systematic reviews, cardiovascular and antithrombotic drugs remain common causes of drug-related admissions, while nervous system drugs appear to have become more commonly implicated. These developments may be considered in future efforts to improve medication safety in primary care. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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13 pages, 4871 KiB

Open AccessArticle

Involvement of Pharmacists in the Emergency Department to Correct Errors in the Medication History and the Impact on Adverse Drug Event Detection

by Clara Goulas, Laura Lohan, Marion Laureau, Damien Perier, Véronique Pinzani, Marie Faucanie, Valérie Macioce, Grégory Marin, Isabelle Giraud, Maxime Villiet, Mustapha Sebbane and Cyril Breuker

J. Clin. Med. 2023, 12(1), 376; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12010376 - 3 Jan 2023

Viewed by 2242

Abstract

(1) Incomplete or wrong medication histories can lead to missed diagnoses of Adverse Drug Effects (ADEs). We aimed to evaluate pharmacist-identified ED errors in the medication histories obtained by physicians, and their consequences for ADE detection. (2) This prospective monocentric study was carried out in an ED of a university hospital. We included adult patients presenting with an ADE detected in the ED. The best possible medication histories collected by pharmacists were used to identify errors in the medication histories obtained by physicians. We described these errors, and identified those related to medications involved in ADEs. We also identified the ADEs that could not have been detected without the pharmacists’ interventions. (3) Of 735 patients presenting with an ADE, 93.1% had at least one error on the medication list obtained by physicians. Of the 1047 medications involved in ADEs, 51.3% were associated with an error in the medication history. In total, 23.1% of the medications involved in ADEs were missing in the physicians’ medication histories and were corrected by the pharmacists. (4) Medication histories obtained by ED physicians were often incomplete, and half the medications involved in ADEs were not identified, or were incorrectly characterized in the physicians’ medication histories. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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13 pages, 990 KiB

Open AccessArticle

Detection and Prevention of Medication Errors by the Network of Sentinel Pharmacies in a Southern European Region

by Anna M. Jambrina, Àlex Santomà, Andrea Rocher, Neus Rams, Glòria Cereza, Pilar Rius, Montserrat Gironès, Clara Pareja, Àngels Franch and Manel Rabanal

J. Clin. Med. 2023, 12(1), 194; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12010194 - 27 Dec 2022

Cited by 5 | Viewed by 2406

Abstract

A medication error (ME) is a drug-related problem that has been recognized as a common and serious threat to patient safety. The aim of this study was to detect and analyze ME reports occurring throughout the therapeutic process through the community’s pharmacies in order to improve the efficacy and safety of medications and contribute to the prevention of future MEs. This was a three-year descriptive, observational, and prospective study to detect and analyze the different MEs reported by the Catalan sentinel pharmacies network (Catalan SePhaNet). In total, 1394 notifications of MEs were reported (an incidence rate of 737.34 cases/100,000 inhabitants). MEs were detected more frequently in primary care centers. Most of the MEs reported were caused by an incorrect, incomplete, illegible, or verbal medical prescription (41.3%). Of the global notifications detected, 71.9% did not reach the patient (categories A and B). The drugs most frequently implicated in the reported ME cases were beta-lactam antibiotics. In 6.0% of the cases, the ME caused injury to the patient (categories E and F). In 72.0% of the global notifications, a pharmacist’s intervention avoided the ME. The importance of a community pharmacy and the role of a pharmacist were demonstrated in aspects related to patient and drug safety. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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18 pages, 2444 KiB

Open AccessArticle

Drug-Drug Interactions among Patients Hospitalized with COVID-19 in Greece

by Marios Spanakis, Petros Ioannou, Sotiris Tzalis, Vasiliki Papakosta, Evridiki Patelarou, Nikos Tzanakis, Athina Patelarou and Diamantis P. Kofteridis

J. Clin. Med. 2022, 11(23), 7172; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11237172 - 2 Dec 2022

Cited by 7 | Viewed by 1990

Abstract

The modulation of the pharmacological action of drugs due to drug-drug interactions (DDIs) is a critical issue in healthcare. The aim of this study was to evaluate the prevalence and the clinical significance of potential DDIs in patients admitted to the University Hospital of Heraklion in Greece with coronavirus disease 2019 (COVID-19). Cardiovascular disorders (58.4%) and diabetes (types I and II) (29.6%) were the most common comorbidities. A high occurrence of DDIs was observed, and clinically significant DDIs that may hamper response to treatment represented 40.3% of cases on admission, 21% during hospitalization, and 40.7% upon discharge. Polypharmacy and comorbidities were associated with a higher prevalence of DDIs in a statistically significant way (p < 0.05, 95% CI). Clinically significant DDIs and increased C-reactive protein values upon admission were associated with prolonged hospitalization. The results reveal that patients admitted due to COVID-19 in Greece often have an additional burden of DDIs that healthcare teams should approach and resolve. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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16 pages, 1476 KiB

Open AccessArticle

Characteristics and Cost of Unscheduled Hospitalizations in Patients Treated with New Oral Anticancer Drugs in Germany: Evidence from the Randomized AMBORA Trial

by Pauline Dürr, Florian Meier, Katja Schlichtig, Anja Schramm, Lukas Schötz, Martin F. Fromm and Frank Dörje

J. Clin. Med. 2022, 11(21), 6392; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11216392 - 28 Oct 2022

Cited by 1 | Viewed by 1442

Abstract

Drug-related problems (e.g., adverse drug reactions, ADR) are serious safety issues in patients treated with oral anticancer therapeutics (OAT). The previously published randomized AMBORA trial showed that an intensified clinical pharmacological/pharmaceutical care program within the first 12 weeks of treatment reduces the number and severity of ADR as well as hospitalization rates in 202 patients. The present investigation focused on unscheduled hospitalizations detected within AMBORA and analyzed the characteristics (e.g., frequency, involved OAT) and cost of each hospital stay. To estimate the potential savings of an intensified care program in a larger group, the absolute risk for OAT-related hospitalizations was extrapolated to all insureds of a leading German statutory health insurance company (AOK Bayern). Within 12 weeks, 45 of 202 patients were hospitalized. 50% of all unscheduled hospital admissions were OAT-related (20 of 40) and occurred in 18 patients. The mean cost per inpatient stay was EUR 5873. The intensified AMBORA care program reduced the patients’ absolute risk for OAT-related hospitalization by 11.36%. If this care program would have been implemented in the AOK Bayern collective (3,862,017 insureds) it has the potential to reduce hospitalization rates and thereby cost by a maximum of EUR 4.745 million within 12 weeks after therapy initiation. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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14 pages, 1482 KiB

Open AccessArticle

New Oral Antitumor Drugs and Medication Safety in Uro-Oncology: Implications for Clinical Practice Based on a Subgroup Analysis of the AMBORA Trial

by Katja Schlichtig, Lisa Cuba, Pauline Dürr, Laura Bellut, Norbert Meidenbauer, Frank Kunath, Peter J. Goebell, Andreas Mackensen, Frank Dörje, Martin F. Fromm and Bernd Wullich

J. Clin. Med. 2022, 11(15), 4558; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11154558 - 4 Aug 2022

Cited by 4 | Viewed by 1796

Abstract

Oral antitumor therapeutics (OAT) bear a high risk for medication errors, e.g., due to drug–drug or drug–food interactions or incorrect drug intake. Advanced age, organ insufficiencies, and polymedication are putting uro-oncological patients at an even larger risk. This analysis sets out to (1) investigate the frequency and relevance of medication errors in patients with prostate cancer or renal cell carcinoma treated with OAT and (2) compile recommendations for clinical practice. This post-hoc subgroup analysis used data collected in the randomized AMBORA trial (2017–2020; DRKS00013271). Clinical pharmacologists/pharmacists conducted advanced medication reviews over 12 weeks after initiation of a new oral regimen and assessed the complete medication process for drug–related problems. Medication errors related to either the OAT, prescribed or prescription-free concomitant medication, or food were classified regarding cause and severity. We identified 67 medication errors in 38 patients within the complete medication within 12 weeks. Thereof, 55% were detected at therapy initiation, 27% were caused by the patients, and 25% were drug–drug or drug–food interactions. Problem-prone issues are summarized in a ‘medication safety table’ to provide recommendations for clinical practice in uro-oncology. Tailored strategies including intensified care by clinical pharmacologists/pharmacists should be implemented in clinical practice to improve medication safety. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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10 pages, 566 KiB

Open AccessArticle

Shortcomings of Administrative Data to Derive Preventive Strategies for Inhospital Drug-Induced Acute Kidney Failure—Insights from Patient Record Analysis

by Stefanie Amelung, David Czock, Markus Thalheimer, Torsten Hoppe-Tichy, Walter E. Haefeli and Hanna M. Seidling

J. Clin. Med. 2022, 11(15), 4285; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11154285 - 23 Jul 2022

Cited by 2 | Viewed by 1457

Abstract

Structured analyses of hospital administrative data may detect potentially preventable adverse drug events (ADE) and therefore are considered promising sources to prevent future harm and estimate cost savings. Whether results of these analyses indeed correspond to ADE that may be preventable in clinical routines needs to be verified. We exemplarily screened all adult inpatients admitted to a German University Hospital (n = 54,032) for International Classification of Diseases-10th revision (ICD-10) diagnoses coding for drug-induced kidney injury (AKI). In a retrospective chart review, we checked the coded adverse events (AE) for inhospital occurrence, causality to drug exposure, and preventability in all identified cases and calculated positive predictive values (ppv). We identified 69 inpatient cases of whom 41 cases (59.4%) experienced the AE in the hospital (ppv-range 0.43–0.80). Causality assessment revealed a rather likely causal relationship between AE and drug exposure in 11 cases (15.9, 11/69, ppv-range 0.17–0.22) whereby preventability measures could be postulated for seven cases (10.1%, 7/69). Focusing on drug-induced AKI, this study exemplarily underlines that ICD-10-code-based ADE prevention efforts are quite limited due to the small identification rate and its high proportion of primarily outpatient events. Furthermore, causality assessment revealed that cases are often too complex to benefit from generic prevention strategies. Thus, ICD-10-code-based calculations might overestimate patient harm and economic losses. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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14 pages, 1778 KiB

Open AccessArticle

Prioritisation of Adverse Drug Events Leading to Hospital Admission and Occurring during Hospitalisation: A RAND Survey

by Annette Haerdtlein, Anna Maria Boehmer, Katharina Karsten Dafonte, Marietta Rottenkolber, Ulrich Jaehde and Tobias Dreischulte

J. Clin. Med. 2022, 11(15), 4254; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11154254 - 22 Jul 2022

Cited by 1 | Viewed by 1457

Abstract

(1) Adverse drug events (ADEs) are a common cause of emergency department visits and occur frequently during hospitalisation. Instruments that facilitate the detection of the most relevant ADEs could lead to a more targeted and efficient use of limited resources in research and practice. (2) We conducted two consensus processes based on the RAND/UCLA appropriateness method, in order to prioritise ADEs leading to hospital admission (panel 1) and occurring during hospital stay (panel 2) for inclusion in future ADE measurement instruments. In each panel, the experts were asked to assess the “overall importance” of each ADE on a four-point Likert scale (1 = not important to 4 = very important). ADEs with a median rating of ≥3 without disagreement were defined as “prioritised“. (3) The 13 experts in panel 1 prioritised 38 out of 65 ADEs, while the 12 experts in panel 2 prioritised 34 out of 63 ADEs. The highest rated events were acute kidney injury and hypoglycaemia (both panels), as well as Stevens–Johnson syndrome in panel 1 and rhabdomyolysis in panel 2. (4) The survey led to a set of ADEs for which there was consensus that they were of particular importance as presentations of acute medication-related harm, thereby providing a focus for further medication safety research and clinical practice. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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15 pages, 1249 KiB

Open AccessArticle

Comprehensibility of Contraindications in German, UK and US Summaries of Product Characteristics/Prescribing Information—A Comparative Qualitative and Quantitative Analysis

by Melanie I. Then, Wahram Andrikyan, Martin F. Fromm and Renke Maas

J. Clin. Med. 2022, 11(14), 4167; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11144167 - 18 Jul 2022

Cited by 1 | Viewed by 1864

Abstract

Contraindications (CIs) in Summaries of Product Characteristics (SmPCs)/Prescribing Information (PI) that lack clarity may pose a risk to medication safety and increase the risk for adverse drug reactions. We assessed and compared SmPCs/PI from three major drug markets regarding comprehensibility from the prescriber perspective, as well as usability in clinical decision support systems. 158 drugs met the following inclusion criteria: marketed in Germany (DE), United Kingdom (UK) and United States (US) and belonged to the 100 most recently FDA approved and/or 100 most frequently prescribed drugs in either country. In the 474 (3 × 158) SmPCs/PI all expressions for absolute CIs were identified, divided into 3999 stand-alone terms and evaluated according to ‘clarity’ and ‘codability’. The average number of absolute CIs per drug differed drastically between the three markets (DE: 11.7, UK: 9.0, US: 4.6). Expressions were frequently unclear (DE: 27.2% (95% CI 25.2–29.2%), UK: 28.5% (26.2–30.9%), US: 22.6% (19.7–25.8%)). Moreover, 60.9% (58.6–63.1%), 63.6% (61.0–66.0%), and 64.7% (61.2–68.1%) of the expressions were not codable in DE, UK, and US, respectively. Taken together, in three major drug markets, statements regarding CIs in SmPCs/PI substantially differ in frequency and frequently lack clarity and codability which poses an unnecessary obstacle to medication safety. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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13 pages, 327 KiB

Open AccessArticle

Potentially Inappropriate Medication and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study

by Raquel Díez, Raquel Cadenas, Julen Susperregui, Ana M. Sahagún, Nélida Fernández, Juan J. García, Matilde Sierra and Cristina López

J. Clin. Med. 2022, 11(13), 3808; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133808 - 30 Jun 2022

Cited by 7 | Viewed by 2568

Abstract

Inappropriate prescribing in the elderly is a risk factor for higher adverse drugs reactions, hospitalisation, and mortality rates. Therefore, it is necessary to identify irrational prescriptions and implement interventions to improve geriatric clinical practices in nursing homes. This study aimed to examine and compare the prevalence of potentially inappropriate medications in nursing home residents using three different updated criteria: 2019 Beers criteria, PRISCUS list, and v2 STOPP criteria, and to determine the prevalence of potential prescribing omissions according to v2 START criteria. A descriptive, observational, and cross-sectional study design was used. A total of 218 residents were involved in this study. Data on drug use were collected from medical charts. Information was screened with the software CheckTheMeds. Potentially inappropriate medications were present in 96.3%, 90.8%, and 35.3% of residents, according to the STOPP, Beers, and PRISCUS criteria or list, respectively. Inappropriate medication was found to be significantly associated with polypharmacy and severe or moderate drug–drug interactions with the three tools and with pathologies and unnecessary drugs only for STOPP criteria. The most frequent inappropriate medications were benzodiazepines and proton pump inhibitors. A regular use of software to review medications in nursing home residents would help to reduce the risk of these drug-related problems. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

16 pages, 2039 KiB

Open AccessArticle

Inconsistencies and Ambiguities in Liver-Disease-Related Contraindications—A Systematic Analysis of SmPCs/PI of Major Drug Markets

by Laura Weisbach, Anna K. Schuster, Michael Hartmann, Martin F. Fromm, Renke Maas and Katrin Farker

J. Clin. Med. 2022, 11(7), 1933; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11071933 - 30 Mar 2022

Cited by 4 | Viewed by 1878

Abstract

Liver disease is a common condition worldwide that can cause alterations in drug disposition and susceptibility to drug toxicities, with increased risk of adverse drug reactions. European Summaries of Product Characteristics (SmPCs) and United States Prescribing Information (US PI) should therefore be comprehensible to prescribers regarding their liver-associated contraindications to ensure safe prescribing. This study aimed to evaluate the ambiguity of terminology used in communicating liver-associated absolute contraindications in SmPCs/PI of commonly prescribed drugs in four major drug markets (Germany, Switzerland, the United Kingdom, and the United States) by assigning wordings to different categories and analyzing their clinical comprehensibility. For US PI, 79% did not contain liver-related contraindications, compared to 2, 13, and 6% of German, Swiss, and British SmPCs, respectively. Study findings indicate that out of 228 examined SmPCs/PI containing liver-related contraindications, 77, 79, 76, and 52% contained unclear wording in the German, Swiss, British, and American drug market, respectively. Only 40% (German), 52% (Swiss), 39% (British), and 29% (American) of SmPCs/PI included terms with explicit wording. Including more precise statements in SmPCs/PI based on laboratory parameters (such as albumin) or scores (e.g., the Child–Pugh score) to objectify the severity of liver disease may improve the clarity of SmPCs/PI and the safety of drug prescription. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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Review

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31 pages, 502 KiB

Open AccessReview

Herb–Drug Interaction in Inflammatory Diseases: Review of Phytomedicine and Herbal Supplements

by Annemarie Lippert and Bertold Renner

J. Clin. Med. 2022, 11(6), 1567; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11061567 - 12 Mar 2022

Cited by 9 | Viewed by 5961

Abstract

Many people worldwide use plant preparations for medicinal purposes. Even in industrialized regions, such as Europe, where conventional therapies are accessible for the majority of patients, there is a growing interest in and usage of phytomedicine. Plant preparations are not only used as alternative treatment, but also combined with conventional drugs. These combinations deserve careful contemplation, as the complex mixtures of bioactive substances in plants show a potential for interactions. Induction of CYP enzymes and pGP by St John’s wort may be the most famous example, but there is much more to consider. In this review, we shed light on what is known about the interactions between botanicals and drugs, in order to make practitioners aware of potential drug-related problems. The main focus of the article is the treatment of inflammatory diseases, accompanied by plant preparations used in Europe. Several of the drugs we discuss here, as basal medication in chronic inflammatory diseases (e.g., methotrexate, janus kinase inhibitors), are also used as oral tumor therapeutics. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

Other

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23 pages, 7305 KiB

Open AccessSystematic Review

Systematic Review of Risk Factors Assessed in Predictive Scoring Tools for Drug-Related Problems in Inpatients

by Lea Jung-Poppe, Hagen Fabian Nicolaus, Anna Roggenhofer, Anna Altenbuchner, Harald Dormann, Barbara Pfistermeister and Renke Maas

J. Clin. Med. 2022, 11(17), 5185; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11175185 - 1 Sep 2022

Cited by 6 | Viewed by 2472

Abstract

Drug-related problems (DRP, defined as adverse drug events/reactions and medication errors) are a common threat for patient safety. With the aim to aid improved allocation of specialist resources and to improve detection and prevention of DRP, numerous predictive scoring tools have been proposed. The external validation and evidence for the transferability of these tools still faces limitations. However, the proposed scoring tools include partly overlapping sets of similar factors, which may allow a new approach to estimate the external usability and validity of individual risk factors. Therefore, we conducted this systematic review and analysis. We identified 14 key studies that assessed 844 candidate risk factors for inclusion into predictive scoring tools. After consolidation to account for overlapping terminology and variable definitions, we assessed each risk factor in the number of studies it was assessed, and, if it was found to be a significant predictor of DRP, whether it was included in a final scoring tool. The latter included intake of ≥ 8 drugs, drugs of the Anatomical Therapeutic Chemical (ATC) class N, ≥1 comorbidity, an estimated glomerular filtration rate (eGFR) <30 mL/min and age ≥60 years. The methodological approach and the individual risk factors presented in this review may provide a new starting point for improved risk assessment. Full article

(This article belongs to the Special Issue Prediction, Detection and Prevention of Medication Errors and Adverse Drug Reactions)

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