Adverse drug reactions caused by drug–drug interactions in elderly outpatients: a prospective cohort study

Abstract

The incidence of DDI-related ADRs in elderly outpatients is high; most events presented important clinical consequences and were preventable or ameliorable.

The Accuracy of Trigger Tools to Detect Preventable Adverse Events in Primary Care: A Systematic Review

“…Therefore, 15 studies with a total of 278,212 patients and 126,197 incidents of positive triggers were included in this review. 17,20,31,[33][34][35][36][37][38][39][40][41][42][43][44][45] Of the 15 included studies, 9 were conducted in the United States, 3 in Scotland, and 1 each in Brazil, France, and Australia (Table 2). Eight studies were published since 2010 and 2 were published before 2000.…”

“…33,36,38 -41,44 Preventable or unplanned hospital admission was the second most commonly studied type of pAE. 42,43,45 Three studies looked at any type of pAE identified in the chart. 20,31,34,35,37 The most commonly used method to identify pAEs was chart review.…”

“…20,31,34,35,37 The most commonly used method to identify pAEs was chart review. 20,31,[33][34][35][36][37][38][39][40][41][42][43][44] Four studies used physicians only as reviewers 35,37,38,40 , 3 used a combination of physicians and pharmacists. 33,36,41 1 used nurses 34 , 1 used pharmacists 44 , and 1 used a combination of physicians and nurses 20 , 5 studies used more than 1 reviewer and all these used at least 2 independent reviewers.…”

“…All 3 studies showed that interrater agreement on presence of an AE was higher than agreement on preventability/ causation. Besides chart review, the other methods to identify pAEs included information from a research database 43 and public data for the National Health System. 45 …”

“…Eight studies 17,20,33,36,39,40,42,44 paired triggers from the IHI tool with other triggers, such as free text searches of charts 33,39,40 , new allergy or "high-priority" codes 20,35,40 , ICD-9 codes 39,40 , antidote administration 33,36 , symptom review 44 , and incident reporting. 33 Triggers that were studied individually included lab abnormality 38 -40,44 , polypharmacy 43,45 , and hospital admission. 31,37,42 The definition of polypharmacy provided by the IHI tool is Ͼ5 medications; however, studies in this review used numbers from 4 to 12.…”