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Which drugs cause preventable admissions to hospital? A systematic review Howard RL; Avery AJ; Slavenburg S; Royal S; Pipe G; Lucassen P; Pirmohamed MBr J Clin Pharmacol 2007[Feb]; 63 (2): 136-47AIMS: 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.|*Drug Utilization Review[MESH]|*Drug-Related Side Effects and Adverse Reactions[MESH]|Adolescent[MESH]|Adult[MESH]|Adverse Drug Reaction Reporting Systems/*statistics & numerical data[MESH]|Aged[MESH]|Health Services Research[MESH]|Hospitalization/*statistics & numerical data[MESH]|Humans[MESH]|Middle Aged[MESH]|Primary Health Care[MESH] |
