Frequency of adverse drug reactions in hospitalized patients: a systematic review and meta‐analysis

Abstract

Purposes To perform a comprehensive systematic review of prospective studies about frequency of adverse drug reactions (ADRs) occurring during hospitalization (ADRIn), including a thorough study quality assessment, meta‐analysis and heterogeneity evaluation. Methods Systematic review of several databases: Pubmed, EMBASE, CINAHL, Cochrane, ISI, International Pharmaceutical Abstracts, Scirus, NHS economic, and others, as well as manual search. Inclusion criteria were: prospective studies (assessing all patients before discharge, by a specialized team, at least once a week); with data about ADRs occurring during hospitalization, using WHO's or similar definition of ADR. Two independent reviewers assessed eligibility criteria, extracted data, and evaluated risk of bias. Results From 4139 studies initially found, 22 were included. Meta‐analysis indicate that ADRs may occur in 16.88% (CI95%: 13.56,20.21%) of patients during hospitalization; however, this estimate has to be viewed with caution because there was significant heterogeneity (I2 = 99%). The most significant moderators of heterogeneity were risk of bias, population, ward, and methodology for ADR identification. Low risk of bias studies adjusted for population (pediatric versus adult) had I2 = 0%. Conclusions These data are useful as a broad characterization of in‐hospital ADRs and their frequency. However, due to heterogeneity, our estimates are crude indicators. The wide variation in methodologies was one of the most important moderators of heterogeneity (even among studies using intensive monitoring). We suggest criteria to standardize methodologies and reduce the risk of bias. Copyright © 2012 John Wiley & Sons, Ltd.

Patient experiences with pharmacogenetic testing in a primary care setting

“…Testing may occur at the time a treatment is needed or prospectively, in advance of treatment. Given the number of hospital admissions due to adverse drug events [2], associated healthcare costs [3,4] and the growing use of prescription drugs in USA [5], efforts to reduce the prevalence of adverse events and inform drug selection may yield both clinical and economic benefits.…”

Detection of adverse drug reaction (ADR)-related hospital admissions: A pilot study using administrative database for ADR monitoring in Thailand

“…Pharm Sci Asia 2017; 44 (3), [142][143][144][145][146][147][148][149][150][151][152][153] rates for ADRs than analysis of database and spontaneous reporting [6][7][8][9] . Nevertheless, medical chart review and intensive monitoring require high resource and technical intensive.…”

“…According to a review of the 25 prospective studies, prevalence of ADRs among hospitalization patients was estimated at 5.3% 6 . Nevertheless, more recent reviews found that prevalence of ADR related hospitalization was approximately 17% 7 while ranging between 0.1% to 54% 8 . It should be noted that findings from the reviews [6][7][8] indicated high variation in prevalence of ADR across studies.…”

“…Nevertheless, more recent reviews found that prevalence of ADR related hospitalization was approximately 17% 7 while ranging between 0.1% to 54% 8 . It should be noted that findings from the reviews [6][7][8] indicated high variation in prevalence of ADR across studies. This variation could possibly be explained by methodology used for ADR, methodology quality, settings, and population [6][7][8] .…”

“…It should be noted that findings from the reviews [6][7][8] indicated high variation in prevalence of ADR across studies. This variation could possibly be explained by methodology used for ADR, methodology quality, settings, and population [6][7][8] . With respect to ADR identification methods, intensive methods for ADR detection such as medical chart review or intensive monitoring consistently found higher prevalence *Corresponding author: montarat.tha@mahidol.ac.th…”