Medication-related adverse events in health care-what have we learned? A narrative overview of the current knowledge

Eur J Clin Pharmacol. 2022 Feb;78(2):159-170. doi: 10.1007/s00228-021-03213-x. Epub 2021 Oct 6.

Abstract

Purpose: Although medication-related adverse events (MRAEs) in health care are vastly studied, high heterogeneity in study results complicates the interpretations of the current situation. The main objective of this study was to form an up-to-date overview of the current knowledge of the prevalence, risk factors, and surveillance of MRAEs in health care.

Methods: Electronic databases (PubMed, MEDLINE, Web of Science, and Scopus) were searched with applicable search terms to collect information on medication-related adverse events. In order to obtain an up-to-date view of MRAEs, only studies published after 2000 were accepted.

Results: The prevalence rates of different MRAEs vary greatly between individual studies and meta-analyses. Study setting, patient population, and detection methods play an important role in determining detection rates, which should be regarded while interpreting the results. Medication-related adverse events are more common in elderly patients and patients with lowered liver or kidney function, polypharmacy, and a large number of additional comorbidities. However, the risk of MRAEs is also significantly increased by the use of high-risk medicines but also in certain care situations. Preventing MRAEs is important as it will decrease patient mortality and morbidity but also reduce costs and functional challenges related to them.

Conclusions: Medication-related adverse events are highly common and have both immediate and long-term effects to patients and healthcare systems worldwide. Conclusive solutions for prevention of all medication-related harm are impossible to create. In the future, however, the development of efficient real-time detection methods can provide significant improvements for event prevention and forecasting.

Keywords: Adverse drug events; Health care; Medication errors; Medication-related adverse events; Patient harm; Patient safety.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Drug-Related Side Effects and Adverse Reactions / economics
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Humans
  • Liver Failure / epidemiology
  • Medication Errors / adverse effects*
  • Medication Errors / statistics & numerical data*
  • Meta-Analysis as Topic
  • Multimorbidity
  • Pharmacovigilance
  • Polypharmacy / statistics & numerical data
  • Renal Insufficiency / epidemiology
  • Risk Factors
  • Systematic Reviews as Topic