Medication-related adverse events in health care\u2014what have we learned? A narrative overview of the current knowledge

O Laatikainen,M Turpeinen,S Sneck

doi:10.1007/s00228-021-03213-x

Abstract

PurposeAlthough 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.MethodsElectronic 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.ResultsThe 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.ConclusionsMedication-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.

Highlights

Several cases of severe medicationrelated adverse events (MRAEs) gained attention worldwide resulting in general understanding of the risk of patient harm presented every time medicines are administered
As this review was not conducted as a systematic review, information drawn from different articles was not filtered according to heterogeneity in terminology concerning MRAEs
It is well established that MRAEs are a prevalent problem in health care, forming as severe of a health hazard in the western countries as malaria and tuberculosis do in the developing countries

Summary

Introduction

Several cases of severe medicationrelated adverse events (MRAEs) gained attention worldwide resulting in general understanding of the risk of patient harm presented every time medicines are administered. The structures of pharmacological care were revolutionized in all stages, from research and development to continuous surveillance. It is apparent that MRAEs cause different levels of patient harm, with the most serious events resulting in an increase in morbidity and mortality worldwide [1,2,3]. The effects of the less serious cases are often poorly detected but are, known to decrease medication compliance and result in suboptimal medical care among patients making the execution of cost-effective, rational medication difficult. Research focusing on MRAEs has been ongoing actively in order to describe the issue and present potential solutions for improved prevention. Understanding the risk factors and mechanisms of MRAEs is important

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