High‐risk medicines associated with clinically relevant medication‐related problems in UK hospitals: A prospective observational study

Abstract

The aim of this prospective observational study was to establish associations between the use of high-risk medicine groups and the study outcome: occurrence of at least 1 moderate or severe preventable medication-related problem. Data on medication-related problems, high-risk medicines, and other potential risk factors were collected from adults on medical wards in 2 UK hospitals. Logistic regression modelling was used to determine relationships between high-risk medicines and the study outcome. Among 1503 eligible admissions, 6 high-risk medicine groups were associated with the study outcome on univariable analysis; multivariable analysis found only systemic antimicrobials and epilepsy medicines to be independently associated with the outcome (adjusted odds ratio 1.44, 95% confidence interval 1.08-1.92 and adjusted odds ratio 1.61, 95% confidence interval 1.16-2.25 respectively).Identification of high-risk medicine groups has potential to permit targeting of patients at highest risk of avoidable medication-related harm, but multivariable analysis suggests risk is likely to be multifactorial.

Analysis of pharmacist-identified medication-related problems at two United Kingdom hospitals: a prospective observational study

“…This prospective study, using an observational study design, involved patients admitted to 30 adult medical wards at two hospitals in South East England. This has been described in detail elsewhere 13,29,30. In summary, the study sites were acute district general hospitals, each with approximately 600 inpatient beds, and broadly representative of other general (non‐specialist) acute NHS trusts in England 30.…”

“…This has been described in detail elsewhere 13,29,30. In summary, the study sites were acute district general hospitals, each with approximately 600 inpatient beds, and broadly representative of other general (non‐specialist) acute NHS trusts in England 30. We included patients admitted to the general, acute, and elderly medicine wards at the study sites.…”

“…Details of high‐risk medicines involved in the clinically relevant MRPs have been published previously 30. This gives the impact of groups of high‐risk medicines on the risk of developing clinically relevant MRPs and explores potential correlation between high‐risk medicines and other risk factors such as age and renal function.…”

Fatores de risco para eventos adversos a medicamentos em pacientes hospitalizados: uma overview de revisões sistemáticas

“…However, a recent study in UK hospitals showed, through multivariate analysis, that systemic antimicrobials (adjusted Odds Ratio: 1.44, 95% Confidence Interval: 1.08-1.92) and medications to treat epilepsy are independently associated with the occurrence of DRPs (adjusted Odds Ratio: 1.61, 95% Confidence Interval: 1.16-2.25), which corroborates the current overview. 24 Regarding the number of medications, it is verified that polymedication increases the probability of ADRs, MEs, drug interactions, drug-disease interactions, falls, HT and mortality; [25][26][27] in addition to hindering adherence to the treatment, configuring an independent risk factor for ADEs. 15 Therefore, patients hospitalized on polymedication, more than any others, must be monitored and properly oriented regarding the use of their medications.…”

Impact of Check of Medication Appropriateness (CMA) in optimizing analgesic prescribing: An interrupted time series analysis

“…PIPs encompass the use of medicines where the possibility of ADEs potentially outweigh any of the expected or perceived benefits, as well as the use of medicines at an incorrect dose or dosing or for longer periods than clinically indicated, but also the use of multiple medicines resulting in relevant interactions, the use of medicines without adequate monitoring and therapeutic omissions (Berthe‐Aucejo et al., 2019). The management of PIPs might be improved by identifying patient populations at risk and by implementing targeted interventions (Boeker et al., 2015; Geeson et al., 2020; Kaufmann et al., 2015; Kjeldsen et al., 2014; Saedder et al., 2014, 2016; Suggett & Marriott, 2016; Thomas et al., 2013).…”