1 Department of Biomedicine - Forskning og uddannelse, Øst, Department of Biomedicine, Health, Aarhus University2 Department of Forensic Medicine - Retskemisk, Department of Forensic Medicine, Health, Aarhus University3 Department of Clinical Medicine - Department of clinical biochemistry, Department of Clinical Medicine, Health, Aarhus University4 Department of Public Health - AU IT, Support, HE, Aarhus, Department of Public Health, Health, Aarhus University5 Department of Biomedicine - Centre for Clinical Pharmacology, Department of Biomedicine, Health, Aarhus University6 Department of Clinical Medicine - Center for Akutforskning, Department of Clinical Medicine, Health, Aarhus University7 Studienævnene på HE - Board of Studies, Health Science, Studienævnene på HE, Health, Aarhus University8 Department of Biomedicine - Forskning og uddannelse, Øst, Department of Biomedicine, Health, Aarhus University9 Department of Clinical Medicine - Center for Akutforskning, Department of Clinical Medicine, Health, Aarhus University
a systematic literature review
Abstract PURPOSE: A medication error (ME) is an error that causes damage or poses a threat of harm to a patient. Several studies have shown that only a minority of MEs actually causes harm, and this might explain why medication reviews at hospital admission reduce the number of MEs without showing an effect on length of hospital stay, readmissions, or death. The purpose of this study was to define drugs that actually cause serious MEs. We conducted a literature search of medication reviews and other preventive efforts. METHODS: A systematic search in PubMed, Embase, Cochrane Reviews, Psycinfo, and SweMed+ was performed. Danish databases containing published patient complaints, patient compensation, and reported medication errors were also searched. Articles and case reports were included if they contained information of an ME causing a serious adverse reaction (AR) in a patient. Information concerning AR seriousness, causality, and preventability was required for inclusion. RESULTS: This systematic literature review revealed that 47 % of all serious MEs were caused by seven drugs or drug classes: methotrexate, warfarin, nonsteroidal anti-inflammatory drugs (NSAIDS), digoxin, opioids, acetylic salicylic acid, and beta-blockers; 30 drugs or drug classes caused 82 % of all serious MEs. The top ten drugs involved in fatal events accounted for 73 % of all drugs identified. CONCLUSION: Increasing focus on seven drugs/drug classes can potentially reduce hospitalizations, extended hospitalizations, disability, life-threatening conditions, and death by almost 50 %.
European Journal of Clinical Pharmacology, 2014, Vol 70, Issue 6, p. 637-45