Prevalence and Preventability of Drug-Related Hospital Readmissions: A Systematic Review

Abstract

Objectives: To summarize the evidence on the prevalence and preventability of drug-related hospital readmissions.

Design: A systematic review was performed of studies that examined drug-related hospital readmissions. PubMed, EMBASE, and the Cochrane Library were searched from inception through August 2016. Reference lists and a citation analysis on Web of Science and Scopus were also consulted. Two reviewers extracted study data with dual assessment of risk of bias. Prevalence and preventability of readmission due to drugs were calculated. Data were qualitatively summarized according to outcome.

Results: Nineteen studies met the eligibility criteria. Nine measured readmissions due to drug-related problems, seven due to adverse drug reactions, two due to adverse drug events, and one due to drug-drug interactions. Rates of readmissions due to drugs varied from 3% to 64% (median 21%, interquartile range (IQR) 14-23%). Readmissions were deemed preventable in 5% to 87% of cases (median 69%, IQR 19-84%). Evidence regarding the risk factors for drug-related readmissions and drugs causing these readmissions was inconsistent.

Conclusion: Although studies show high variability in prevalence and preventability of drug-related hospital readmissions, readmissions due to drugs seem to occur often, especially in older adults. Further research is needed to specify the causes of preventable readmissions and implement effective interventions to reduce medication-related hospital admissions.

Keywords: adverse drug events; adverse drug reactions; drug-related problems; drug-related side effects; hospital readmission; medication errors.