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. 2007 Feb;63(2):136-47.
doi: 10.1111/j.1365-2125.2006.02698.x. Epub 2006 Jun 26.

Which drugs cause preventable admissions to hospital? A systematic review

R L Howard  1 , A J Avery, S Slavenburg, S Royal, G Pipe, P Lucassen, M Pirmohamed
Affiliations

Which drugs cause preventable admissions to hospital? A systematic review

R L Howard et al. Br J Clin Pharmacol. 2007 Feb.

Abstract

Aims: 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.

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Figures

Figure 1
Figure 1
Selection process of eligible studies
Figure 2
Figure 2
Scattergram showing the relationship between the number of patients studied and the proportion of preventable drug-related admissions to hospital
See this image and copyright information in PMC

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