A Systematic Review of Risk Factors of Adverse Drug Reactions in Hospitalized Patients

Abstract

Background: Adverse drug reactions (ADRs) pose both financial and health encumbrances for patients. Although prevalence and risk factors associated with ADRs have been published in many studies, most of them lack the statistical evidence for predictors. The aim of this study was to review the published literature to determine the risk factors in the adult and elderly population for ADRs. An electronic search of articles published in English language in databases such as Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Scopus, and Google Scholar was conducted in between January 2001 and April 2018. The search terms used were: “ADRs,” “drug-related problems,” “risk factors,” “general adult population,” “elderly patients,” and “hospital admission.” For inclusion in the review, studies had to include an explicit definition of what was considered an ADR and/or an explicit assessment of causality, as well as a clear description of the method used for ADR identification. Polypharmacy was the major risk factor of ADR followed by comorbidities and length of hospital stay.

Prevalence, characteristics and predicting risk factors of adverse drug reactions among hospitalized older adults: A systematic review and meta-analysis

“…Having four or more comorbidities was also reported by three previous studies by Alhawassi et al, 10 Mudigubba et al 54 and Green et al 64 More comorbidity usually requires concomitant use of numerous medications, which, in turn, increases the risk of ADR. On the contrary, Catananti et al 65 explained that ADR risk with heart failure might be attributed to the use of cardiovascular drugs, which were shown by Kongkaew et al 32 to be the most frequent culprit of ADR in adults and older adults.…”

“…Thus, a vigilant evaluation of pharmacotherapy among hospitalized older adults remarkably reduces the risk of incurring ADR during hospitalization. 54,55 Because of the strong association between ADR and the number of medications as well as the use of PIMs, identification of PIMs and systematic deprescribing in hospitalized older patients is probably one of the most effective strategies for mitigating the burden of in-hospital acquired ADRs. 58 To this effect, the application of STOPP and The Norwegian General Practice criteria (NORGEP) to hospitalized older patients demonstrated a significant circumvention of the use of PIMs, and thus reduction in risk of ADRs.…”

“…15,16 This reproduces the fact that aging is associated with multiple morbidity, renal impairment and polypharmacy, thus ultimately resulting in increased ADR occurrences. 54,55…”

Incidence and predictors of Adverse Drug Reaction (ADR) among adult HIV positive patients on anti-retroviral treatment in Arba Minch town public health facilities, southern Ethiopia: A retrospective cohort study, 2020

“…Differences on the risk of ADRs between male and female might be because of a number of sex related physiological differences, such as having lower body weight, differences in activity of enzymes, reduced renal clearance due to their lower glomerular filtration rate and difference on absorption, distribution, metabolization and excretion of drugs at different rates compared with men. Additionally, women use more medications compared to men such as contraceptives, hormonal supplements, minerals and vitamins, especially during their reproductive life that might predispose them to more ADRs compared to men [ 42 , 43 ].…”

“…The possible explanation for the higher incidence of ADRs among patients with advanced clinical disease might be due to an increased risk of opportunistic infections and associated with this there would be also use of multiple drugs. The study suggest that patients with multiple morbidity may have altered pharmacodynamics and pharmacokinetic mechanisms due to drug-disease interaction which predisposes them to ADRs and the use of multiple drugs also increases the risk of ADRs due to drug- drug interactions [ 42 ]. This finding implies that the need of strengthening the implementation of test and treat strategies in order to reduce developing advanced clinical stage of disease in turn to reduce ADRs among them.…”