Adverse drug reactions in primary care: a scoping review

Khalil, Hanan; Huang, Chongmei

doi:10.1186/s12913-019-4651-7

Cited by 94 publications

(77 citation statements)

References 54 publications

(94 reference statements)

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“…Tache et al examined medication-related adverse events, but the review combined both primary and secondary care settings and included six ambulatory-based studies only up to 2011 [ 13 ]. Another review has been conducted by Khalil et al, however no meta-analysis, evaluation of study quality, heterogeneity analysis, and preventability assessment were performed [ 17 ]. Ascertaining the burden of ADRs in the community has significant public health implication, as this information may help in prioritising areas of improvement, and thus potentially decreasing patients’ risk of untoward therapeutic consequences.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis

et al. 2021

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Background Adverse drug reactions (ADRs) represent a major cause of iatrogenic morbidity and mortality in patient care. While a substantial body of work has been undertaken to characterise ADRs in the hospital setting, the overall burden of ADRs in the primary care remains unclear. Objectives To investigate the prevalence of ADRs in the primary care setting and factors affecting the heterogeneity of the estimates. Methods Studies were identified through searching of Medline, Embase, CINAHL and IPA databases. We included observational studies that reported information on the prevalence of ADRs in patients receiving primary care. Disease and treatment specific studies were excluded. Quality of the included studies were assessed using Smyth ADRs adapted scale. A random-effects model was used to calculate the pooled estimate. Potential source of heterogeneity, including age groups, ADRs definitions, ADRs detection methods, study setting, quality of the studies, and sample size, were investigated using sub-group analysis and meta-regression. Results Thirty-three studies with a total study population of 1,568,164 individuals were included. The pooled prevalence of ADRs in the primary care setting was 8.32% (95% CI, 7.82, 8.83). The percentage of preventable ADRs ranged from 12.35–37.96%, with the pooled estimate of 22.96% (95% CI, 7.82, 38.09). Cardiovascular system drugs were the most commonly implicated medication class. Methods of ADRs detection, age group, setting, and sample size contributed significantly to the heterogeneity of the estimates. Conclusion ADRs constitute a significant health problem in the primary care setting. Further research should focus on examining whether ADRs affect subsequent clinical outcomes, particularly in high-risk therapeutic areas. This information may better inform strategies to reduce the burden of ADRs in the primary care setting.

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Section: Introductionmentioning

confidence: 99%

Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis

et al. 2021

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“…Drugs for psychiatric conditions were the most frequently involved in multidrug interactions, accounting for 23.3% of the drugs involved (Table 3). Several prior studies of two-drug interacting pairs made similar observations [12][13][14][15][16][17]8]. The preponderance of psychotropic drugs in multidrug interactions may reflect the rising incidence of psychotropic polypharmacy [18].…”

Section: Discussionmentioning

confidence: 67%

Potential Multidrug Interactions in Elderly Ambulatory Patients

Anand¹,

Wallace²,

Chase³

2020

Preprint

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Aim. Polypharmacy may increase the prevalence of potential multidrug interactions (pMDIs), where one drug interacts with two or more other drugs, possibly amplifying the risk of a potential adverse drug event (pADE). The major goal of this study was to estimate the prevalence of amplifying pMDIs in an ambulatory cohort of older patients. Methods. Current medication lists of 22033 randomly chosen outpatients ≥50 years old were extracted from the New York Presbyterian Hospital (NYP) data warehouse. Network analysis identified patients prescribed three or more interacting drugs from their current medication lists. Potentially harmful interactions were identified from the NYP drug-drug interaction alerting system. pMDIs were considered amplifying if the interactions increased the probability of a pADE through pharmacokinetic, pharmacodynamic or conditional mechanisms. Results. pMDIs were identified in 5.1% of the medication lists; 3.4% were three-drug and 1.1% were four-drug pMDIs. The most common drugs involved were psychotropic, comprising 23.3% of the total drugs. The most common pADEs associated with the interactions were serotonin syndrome (17.2%), seizures (14.4%), prolonged QT interval (15.8%) and bleeding (14.4%). pADE amplification risk was identified in 71.8% of three-drug pMDIs when one drug interacted with two others, 97.8% when all three interacted with each other, and 93% for four-drug pMDIs. Conclusion. Our data suggest that approximately 5% of elderly ambulatory patients may be exposed to pMDIs which amplify the probability of associated adverse drug events. The recent and persistent rise in polypharmacy will likely increase the prevalence of pMDIs and potential exposure to serious adverse events.

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“…However, improper usage of those drugs can cause severe damage by creating new adverse situations, be it morbidity or mortality 16 . From 1.5 to 35%, errors related to medication were reported to the patients under hospitalization, and DRPs were seen to be common.…”

Section: Medication Errormentioning

confidence: 99%

An Overview on Patient-Centered Clinical Services

et al. 2021

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Drug-related problems (DRPs) had often been a concern in the system that needed to be detected, avoided, and addressed as soon as possible. The need for a clinical pharmacist becomes even more important. He is the one who can not only share the load but also be an important part of the system by providing required advice. They fill out the patient's pharmacotherapy reporting form and notify the medical team's head off any drug-related issues. General practitioners register severe adverse drug reactions (ADRs) yearly. As a result of all of this, a clinical pharmacist working in and around the healthcare system is expected to advance the pharmacy industry. Its therapy and drugs can improve one's health quality of life by curing, preventing, or diagnosing a disease, sign, or symptom. The sideshows, on the other hand, do much harm. Because of the services they offer, clinical pharmacy has grown in popularity. To determine the overall effect and benefits of the emergency department (ED) clinical pharmacist, a systematic review of clinical practice and patient outcomes will be needed. A clinical pharmacist's anatomy, toxicology, pharmacology, and medicinal chemistry expertise significantly improves a patient's therapy enforcement. It is now important to examine the failure points of healthcare systems as well as the individuals involved.

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Adverse drug reactions in primary care: a scoping review

Cited by 94 publications

References 54 publications

Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis

Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis

Potential Multidrug Interactions in Elderly Ambulatory Patients

An Overview on Patient-Centered Clinical Services

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