OBJECTIVE: Most medications are prescribed, dispensed, and administered in ambulatory care settings, yet little information exists on the adverse effects of drugs in this setting. This review was conducted to estimate the prevalence of adverse drug events (ADEs) and the proportion of preventable ADEs in ambulatory care settings; compare data for different age groups including children, adults, and elderly patients; and review drug classes most commonly associated with ADEs. DATA SOURCES: Four electronic databases-PubMed (1966-March 2011), International Pharmaceutical Abstracts (1970-March 2011), EMBASE (1980-March 2011), and the Cochrane Database of Systematic Reviews (1993-March 2011)-were systematically searched for published data. Bibliographies of retrieved articles were searched individually for additional relevant studies. STUDY SELECTION: A standardized definition of an ADE was used to select studies in populations living in the community, with medical visits to primary care facilities, nonspecialty ambulatory care facilities, and/or admissions to a hospital for medication-related adverse events. DATA EXTRACTION: Data were extracted using a standardized table. Forty-three studies met our inclusion criteria. DATA SYNTHESIS: The median ADE prevalence rate for retrospective studies was 3.3% (interquartile range [IQR] 2.3-7.1%) vs 9.65% (IQR 3.3-17.35%) for prospective studies. Median preventable ADE rates in ambulatory care-based studies were 16.5%, and 52.9% for hospital-based studies. Median prevalence rates by age group ranged from 2.45% for children to 5.27% for adults, 16.1% for elderly patients, and 3.45% for studies including all ages. CONCLUSIONS: Despite a recent increase in publications on ADEs in the ambulatory care setting, most studies remain hospital based. Notable differences in prevalence rates by age groups and by responsible drug categories provide guidance on how to direct attention toward effective targets for improvement of medication safety in ambulatory care settings.
OBJECTIVE: Most medications are prescribed, dispensed, and administered in ambulatory care settings, yet little information exists on the adverse effects of drugs in this setting. This review was conducted to estimate the prevalence of adverse drug events (ADEs) and the proportion of preventable ADEs in ambulatory care settings; compare data for different age groups including children, adults, and elderly patients; and review drug classes most commonly associated with ADEs. DATA SOURCES: Four electronic databases-PubMed (1966-March 2011), International Pharmaceutical Abstracts (1970-March 2011), EMBASE (1980-March 2011), and the Cochrane Database of Systematic Reviews (1993-March 2011)-were systematically searched for published data. Bibliographies of retrieved articles were searched individually for additional relevant studies. STUDY SELECTION: A standardized definition of an ADE was used to select studies in populations living in the community, with medical visits to primary care facilities, nonspecialty ambulatory care facilities, and/or admissions to a hospital for medication-related adverse events. DATA EXTRACTION: Data were extracted using a standardized table. Forty-three studies met our inclusion criteria. DATA SYNTHESIS: The median ADE prevalence rate for retrospective studies was 3.3% (interquartile range [IQR] 2.3-7.1%) vs 9.65% (IQR 3.3-17.35%) for prospective studies. Median preventable ADE rates in ambulatory care-based studies were 16.5%, and 52.9% for hospital-based studies. Median prevalence rates by age group ranged from 2.45% for children to 5.27% for adults, 16.1% for elderly patients, and 3.45% for studies including all ages. CONCLUSIONS: Despite a recent increase in publications on ADEs in the ambulatory care setting, most studies remain hospital based. Notable differences in prevalence rates by age groups and by responsible drug categories provide guidance on how to direct attention toward effective targets for improvement of medication safety in ambulatory care settings.
Authors: Tim Johansson; Muna E Abuzahra; Sophie Keller; Eva Mann; Barbara Faller; Christina Sommerauer; Jennifer Höck; Christin Löffler; Anna Köchling; Jochen Schuler; Maria Flamm; Andreas Sönnichsen Journal: Br J Clin Pharmacol Date: 2016-05-07 Impact factor: 4.335
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Authors: Samantha I Pitts; Noah Barasch; Andrew T Maslen; Bridgette A Thomas; Leonard P Dorissaint; Krista G Decker; Sadaf Kazi; Yushi Yang; Allen R Chen Journal: Appl Clin Inform Date: 2019-05-22 Impact factor: 2.342
Authors: Gordon D Schiff; Harry Reyes Nieva; Paula Griswold; Nicholas Leydon; Judy Ling; Madeleine Biondolillo; Sara J Singer Journal: Health Serv Res Date: 2016-12 Impact factor: 3.402
Authors: Gordon D Schiff; Elissa Klinger; Alejandra Salazar; Jeffrey Medoff; Mary G Amato; E John Orav; Shimon Shaykevich; Enrique V Seoane; Lake Walsh; Theresa E Fuller; Patricia C Dykes; David W Bates; Jennifer S Haas Journal: J Gen Intern Med Date: 2018-10-05 Impact factor: 5.128
Authors: Derbew Fikadu Berhe; Katja Taxis; Flora M Haaijer-Ruskamp; Afework Mulugeta; Yewondwossen Tadesse Mengistu; Johannes G M Burgerhof; Peter G M Mol Journal: Br J Clin Pharmacol Date: 2017-06-15 Impact factor: 4.335