PMID- 12086559
OWN - NLM
STAT- MEDLINE
DCOM- 20021126
LR  - 20220331
IS  - 1060-0280 (Print)
IS  - 1060-0280 (Linking)
VI  - 36
IP  - 7-8
DP  - 2002 Jul-Aug
TI  - Preventable drug-related hospital admissions.
PG  - 1238-48
AB  - OBJECTIVE: To estimate the prevalence of preventable drug-related hospital 
      admissions (PDRAs) and to explore if selected study characteristics affect 
      prevalence estimates. METHODS: Keyword search of MEDLINE (1966-December 1999), 
      International Pharmaceutical Abstracts (1970-December 1999), and hand search. Two 
      reviewers independently selected studies published in peer-reviewed journals and 
      extracted crude prevalence estimates and study characteristics. Trials had to 
      specifically address consequences of drug therapy requiring hospital admission 
      and include a quantitative preventability assessment. Stratified analysis and 
      meta-regression were used to explore the association between study 
      characteristics and prevalence estimates. DATA SYNTHESIS: Fifteen studies 
      reported a median PDRA prevalence of 4.3% (interquartile range [IQR] 3.1-9.5%). 
      The median preventability rate of drug-related admissions was 59% (IQR 50-73%). 
      No evidence of publication bias related to study size could be determined. 
      Because the individual study results were highly heterogeneous (Cochran's Q = 
      176, df = 14; p < 0.001), no meta-analytic summary estimate was computed. 
      Stratified analysis suggested an association between prevalence estimates and 3 
      study characteristics: exclusion of first admissions (readmission studies: 
      average PDRA prevalence of 14.0 %, estimated prevalence OR = 3.7); mean age of 
      admissions >70 (OR = 2.1); and inclusion of "indirect" drug-related morbidity, 
      such as omission errors or therapeutic failure (OR = 1.9). There was little 
      evidence of other associations with prevalence estimates, such as selection of 
      specific hospital units, exclusion/inclusion of planned admissions, country, and 
      specified methods of PDRA case ascertainment. CONCLUSIONS: Drug-related morbidity 
      is a significant healthcare problem, and a great proportion is preventable. Study 
      methods in prevalence reports vary and should be considered when interpreting 
      findings or planning future research.
FAU - Winterstein, Almut G
AU  - Winterstein AG
AD  - Department of Pharmacy Health Care Administration, College of Pharmacy, 
      University of Florida, Gainesville, FL 32610-0496, USA. almut@cop.ufl.edu
FAU - Sauer, Brian C
AU  - Sauer BC
FAU - Hepler, Charles D
AU  - Hepler CD
FAU - Poole, Charles
AU  - Poole C
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
SB  - IM
MH  - *Drug-Related Side Effects and Adverse Reactions
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - *Medication Errors/prevention & control/statistics & numerical data
MH  - *Morbidity
MH  - Prevalence
EDAT- 2002/06/28 10:00
MHDA- 2002/11/28 04:00
CRDT- 2002/06/28 10:00
PHST- 2002/06/28 10:00 [pubmed]
PHST- 2002/11/28 04:00 [medline]
PHST- 2002/06/28 10:00 [entrez]
AID - 10.1345/aph.1A225 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2002 Jul-Aug;36(7-8):1238-48. doi: 10.1345/aph.1A225.