Table 4.
Medicine classes associated with medicine-related problems leading to hospital admission
| Study | No. of patients | No. of MRPs | Cardiovascular disease | Anti-infective | Anticancer | Antidiabetic | Anti-inflammatory/analgesic | Others |
|---|---|---|---|---|---|---|---|---|
| Number (%) | Number (%) | Number (%) | Number (%) | Number (%) | Number (%) | |||
| Adverse drug reactions | ||||||||
| Ahren et al. [28] | 856 | 75 | CVD drugs, 73 (46.5); diuretics, 22 (14); ACEI/antihypertension/anticoagulants | NR | Chemotherapy, 10 (6.37) | Insulin, 1 (0.64); oral hypoglycaemic, 1 (0.64) | NR | CNS drugs, 50 (31.8) |
| Carrasco-Garrido et al. [15] | 350 835 | 350 835 | Anticoagulants, 26 546 (7.57) | Antibiotics, 22 144 (6.31) | Antineoplastic/immunosuppressant, 75 760 (21.6) | NR | Adrenal corticosteroids, 47 539 (13.6) | NR |
| Van der Hooft et al. [16]. | 2238 | 115 | CVD drugs, 32 (27.8) | Anti-infectives, 6 (5.22); antimalarials, 1 (0.87) | Antineoplastic/immunosuppressant, 22 (31.3) | NR | NSAIDs, 9 (7.83) | GIT drugs, 3 (2.61); CNS drugs, 19 (16.5); blood-forming organs, 40 (34.8); hormones, 11 (9.57); respiratory, 1 (0.87) |
| McDonnell and Jacobs [17] | 20 166 | 158 | Anticoagulants/cardiotonics/antihypertensives/diuretics, 54 (34.2) | Antibiotics, 10 (0.87) | Anticancer/immunosuppressant, 36 (22.8) | Antidiabetics, 17 (11.04) | Opiates, 4 (2.59); NSAIDs, 9 (5.84) | Anti-epileptics/antidepressants/antipsychotics, 21 (13.6); antihyperlipidaemics, 3 (1.95) |
| Ruiter et al. [18] | 2 127 133 | 27 653 | Anticoagulants | NR | NR | Antidiabetics | Salicylates/antirheumatics | |
| Wawruch et al. [20] | 600 | 47 | ACEI/β-blocker/CCB/digoxin/amiodarone/potassium-sparing diuretics/warfarin/ATB, 35 (74.4) | NR | NR | NR | Opioid, 1 (2.1); NSAIDs/corticosteroids, 3 (6.4) | Propulsive/atypical antipsychotic, 2 (4.25); statin, 2 (4.25) |
| Wu et al. [19] | 6 830 067 | 557 978 | CVD drugs, 851 (0.15) | Systemic antibiotics/anti-infective/antiparasitic, 8314 (1.49) | NR | NR | Analgesics/antipyretics/anti-inflammatory, 877 (0.16) | CNS drugs/anti-epileptics/antiparkinson/sedative/hypnotic/anti-anxiety/psychotropic, 7061 (1.26); GIT drugs, 857 (0.15) |
| Franceschi et al. [56] | 1756 | 102 | Antiplatelets/CVD disorders/warfarin/digoxin/ amiodarone/ACEI, 75 (73.4) | Antibiotics, 30 (2.9) | NR | NR | Analgesics, 30 (2.9); NSAID, 24 (23.5); aspirin, 14 (13.7) | GIT drugs, 48 (47.1) |
| Hopf et al. [22] | 1101 | 30 | CVD drugs, 16 (53.3) | NR | Cytotoxic, 2 (6.67) | NR | Opioid, 5 (16.7); NSAID, 9 (30) | Antipsychotic, 3 (0.1) |
| Pérez Menéndez-Conde et al. [50] | 252 | 49 | CVD drugs, 7 (14) | NR | Antineoplastic/immunosuppressant, 19 (38) | NR | NR | Hormone therapy, 15 (30.6); thyroid drugs, 12 (23.5) |
| Onder et al. [57] | 28 411 | 1704 | Diuretics/CCB/ digoxin/anticoagulants/ACEI/antiplatelet, 497 (29.2) | Antibiotics, 63 (3.69) | Antineoplastic, 30 (1.76) | NR | NSAIDs, 81 (4.75); corticosteroids, 40 (2.34) | Antipsychotic, 40 (2.35); benzodiazepines, 33 (1.94) |
| Thuermann et al. [29] | 41 375 | 993 | Antithrombotic, 267 (26.9); CCB/β-blocker/digitalis, 50–80 (5–8) | NR | NR | Oral antidiabetic, 63 (6.3); insulin, 152 (15.3) | NSAIDs, 153 (15.4) | NR |
| Mjörndal et al. [23] | 681 | 99 | Amlodipine/atenolol/cholestyramine/cilazapril/digoxin/diltiazem/enalapril/felodipine/furosemide/glyceryl trinitrate/hydrochlorothiazide/irbesartan/isosorbide/metholazone/metoprolol/nifedipine/ramipril/sotalol/verapamil/aspirin/dipyridamole/ticlopidine/warfarin, 59 (59.6) | Ceftriaxone/ciprofloxacin/influenza vaccine/metronidazole, 5 (5.05) | Amsaparine/azathioprine/chlorambucil/cyclophosphamide/doxorubicin/tamoxifen, 7 (7.05) | Glibenclamide, 2 (2.02); human insulin, 6 (6.06); metformin, 1 (1.01) | Dextropropoxyphene/naproxen/paracetamol, 4 (4.04); betamethasone/budesonide/cortisone/methyl prednisolone/ketobemidone, 10 (10.1) | Antiparkinson, 16 (16.2); flunitrazepam, 2 (2.02); nefazodone, 1 (1.01), oxazepam, 2 (2.02); paroxetine, 1 (1.01); risperidone, 1 (1.01); venlafaxine, 2 (2.02); amsacrine, 1 (1.01); azathioprine, 2 (2.02); chlorambucil, 1 (1.01); antiparkinson, 4 (4.04); GIT drugs, 12 (12.1); hormone replacement therapy, 10 (10.1) |
| Gholami et al. [24] | 518 | 105 | Diltiazem, 25 (23.5); atenolol, 3 (3) | NR | NR | NR | NR | NR |
| Pirmohamed et al. [21] | 18 820 | 1225 | Diuretics, 334 (27.3); warfarin, 129 (10.5); ACEI and ATB, 94 (7.7); β-blocker, 83 (6.8); digoxin, 36 (2.9); clopidogrel, 29 (2.4) | NR | NR | NR | Opioid, 73 (6); NSAID, 363 (29.6); aspirin, 218 (17.8); prednisolone, 31 (2.5) | Antidepressants, 87 (7.1) |
| Wasserfallen et al. [51] | 4840 | 339 | CVD, 107 (31.6); anticoagulant, 31 (9.14); cardiotonic, 21 (6.19); hypotensive, 27 (7.96); diuretic, 23 (6.79); β-blocker, 5 (1.49) | Antibiotics, 16 (4.72) | Cytostatic, 84 (24.78) | Antidiabetic, 17 (5.02) | NSAIDs, 30 (8.85); corticosteroids, 14 (4.13) | Psychotropic, 18 (5.31); psycholeptic, 13 (3.83) |
| Mannesse et al. [52] | 106 | 13 | CVD drugs | NR | NR | NR | NR | CNS drugs; GIT drugs |
| Van Der Hooft et al. [25] | 668 714 | 12 238 | Anticoagulants, 2185 (17.9); diuretics, 979 (7.99) | NR | Cytostatic/immunosuppressive, 1809 (14.8) | Insulin/other antidiabetics, 541 (4.42) | Salicylates, 509 (4.16); antirheumatic, 496 (4.05) | NR |
| Varallo et al. [26] | 308 | 168 | CVD drugs, 63 (37.7) | NR | NR | NR | NR | CNS drugs, 58 (34.6); GIT drugs, 34 (20); respiratory, 10 (5.7) |
| Malhotra et al. [53] | 578 | 32 (ADR) | Digoxin, 2 (6.25) | Antituberculosis, 5 (15.6); penicillins, 2 (6.25) | Cancer chemotherapy, 5 (15.6) | Oral hypoglycaemic, 12 (37.5) | NSAIDs, 6 (18.8) | Phenytoin, 2 (6.25) |
| Jayarama et al. [27] | 133 | 50 | Fluoroquinolones, 4 (8%); cotrimoxazole, 1 (2); rifampicin/isoniazide, 2 (4) | NR | NR | Insulin, 8 (6) | NSAIDs, 16 (32); glucocorticoids, 10 (20) | Phenytoin, 2 (4); domeperidone, 1 (2); lignocaine, 1 (2); esomeprazole, 1 (2); flunarizine, 1 (2); prochloperazine, 1 (2); iron sucrose, 1 (2); pyrazinamide, 1 (2) |
| Adverse drug events | ||||||||
| Briant et al. [33] | 6579 | 131 | ACEI/diuretics, anticoagulants, warfarin, 7 (0.76); amiodarone, CCB, digoxin, β-blocker, 59 (45.1) | Antibiotics, 18 (13.7) | NR | NR | NSAIDS, 9 (6.9); aspirin, 8 (6.11) | Centrally acting, 23 (17.5); opiates, 8 (6.11) |
| Gurwitz et al. [32] | 30 397 | 1520 | CVD drugs, 720 (47.2); diuretics, 203 (13.3); anticoagulants, 121 (7.9) | Antibiotics, 224 (14.7) | NR | Hypoglycaemic, 103 (6.8) | Opioid, 74 (5.9); non-opioid analgesics, 180 (11.8); steroids, 80 (5.3) | Neuropsychiatric, 131 (8.6); GIT drugs, 321 (21.1); metabolic/endocrine, 210 (13.8) |
| Peyriere et al. [36] | 156 | 32 | CVD, 13 (39.5) | Anti-infective, 4 (13.2) | Antineoplastic, 3 (7.9) | NR | NR | Psychotropic, 10 (31.6) |
| Chan et al. [37] | 240 | 73 | ACEI/diuretics/β-blocker/calcium antagonist/digoxin/nitrates/warfarin, 61 (83.6) | NR | NR | NR | Aspirin, 5 (6.85); corticosteroids, 7 (9.59); NSAIDs, 6 (8.22) | Benzodiazepines, 6 (8.22); phenothiazines, 6 (8.22); antidepressants, 1 (1.36); SSRI, 5 (6.85); tricyclics, 4 (5.47); antiparkinsonian, 3 (4.1); anti-epileptics, 1 (1.36) |
| Edwards et al. [34] | 62 064 | 1495 | Anticoagulant/antiplatelet/ACEI and ATB/diuretics/β-blocker/CCB/anti-arrhythmic/antihypertensive, 572 (38.3) | Antimicrobial, 47 (3.14) | Antineoplastic, 15 (1) | Antidiabetic, 121 (8.29) | Opioid, 136 (9.1); NSAID/acetaminophen, 250 (16.7) | Antidepressant, 60 (4.01); antipsychotic, 11 (11.73) |
| Benkirane et al. [35] | 1390 | 76 | Anticoagulants, 4 (5.2) | Antibiotics, 5 (6.6) | NR | NR | Analgesics, 13 (17.1); anti-inflammatory, 9 (11.8) | GIT, 20 (26.3) |
| Medicine-related problem | ||||||||
| Claydon-Platt et al. [39] | 5205 | 686 | NR | NR | NR | Antidiabetic, 6 (0.87) | Analgesics, 5 (0.73) | Benzodiazepines, 5 (0.73) |
| Rodenburg et al. [41] | 41 785 | 14 207 | CVD, 7690 (54); anticoagulants and salicylates, 8988 (63.3); high- and low-ceiling diuretics, 2242 (15.8); cardiotonic glycosides, 932 (6.56) | NR | NR | NR | NR | NR |
| Yee et al. [42] | 2169 | 274 | Anticoagulants, 10 (3.64); diuretic, 4 (1.45); ACEI, 3 (1.09); β-blocker, 3 (1.09); CCB, 3 (1.09); α-blocker, 3 (1.09) | Anti-infective, 6 (2.18) | Chemotherapy, 6 (2.18) | NR | Narcotic analgesic, 3 (1.09); aspirin and NSAIDs, 4 (1.45) | Antipsychotic, 2 (30.73) |
| Howard et al. [45] | 4039 | 263 | Aspirin, β-blocker, anti-epileptic, diuretic, digoxin, nitrates | NR | NR | Sulfonyl urea, insulin | NSAID | NR |
| Santamaria-Pablos et al. [43] | 163 | 53 | CVD: nitroglycerine, furosemide, digoxin, diltiazem, quinapril | Systemic anti-infective | NR | NR | NR | CNS, locomotive system, GIT drugs, hormonal, 4% |
| Leendertse et al. [5] | 13 000 | 714 | Antiplatelet, 29 (4.06); oral anticoagulants, 21 (2.94) | NR | NR | Antidiabetic, 41 (5.74) | NSAID, 17 (2.38) | CNS, 17 (2.38) |
| Koneri et al. [31] | 2340 | 150 | CVD, antihypertensive | Antibiotic, antituberculosis, antiretroviral | NR | Antidiabetic | NSAID, steroid | Anticonvulsant, respiratory drug, H1 antagonist |
| Jutti-Patinen and Neuvonen [46] | 1511 | 76 | Warfarin, 15 (19.7); heparin, 5 (6.58); alteptase/streptase, 2 (2.64); anticoagulants, 20 (26.4); antihypertensive, 1 (1.32) | Antibiotic, 2 (2.64) | Cytostatic/immunosuppressant, 23 (30) | Corticosteroids, 4 (5.26); NSAIDs, 12 (15.8) | Antipsychotic, 2 (2.64) | |
| Repp et al. [30] | 48 | 19 | Anticoagulants | Antimicrobial | Immunosuppressant | NR | NR | NR |
| Singh et al. [47] | 3560 | 118 | Antihypertensive | NR | Chemotherapy | Insulin; hypoglycaemic agents | NR | NR |
| Samoy et al. [48] | 565 | 136 | CVD, anticoagulants, furosemide, warfarin, ramipril, spironolactone | Antibiotics | NR | Hypoglycaemics | NSAIDs, aspirin | CNS |
| Rogers et al. [59] | 409 | 57 | CVD, 11 (19.3) | NR | NR | NR | NR | NR |
| Zed et al. [55] | 1071 | 122 | NR | Antimicrobial, 20 (16.4) | NR | NR | Opioid-containing analgesics, 20 (16.4) | Antipsychotic, 17 (13.9); benzodiazepines, 11 (9.02) |
| Andreazza et al. [54] | 350 | 123 | CVD, 17 (14); captopril, 6 (5.14) | NR | NR | NR | NR | CNS, 16 (13.2); lithium, 6 (4.87) |
Abbreviations are as follows: ACEI, angiotensin-converting enzyme inhibitor; ATB, angiotensin receptor blocker; CCB, calcium channel blocker; CNS, central nervous system; CVD, cardiovascular disease; GIT, gastrointestinal tract; MRP, medicine-related problem; NR, not reported; NSAID, nonsteroidal anti-inflammatory drug; RR, relative risk; SSRI, selective serotonin reuptake inhibitor. The number and percentage of medicines associated with MRPs is calculated in reference to the number of MRPs reported in the study.