Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Pharmacotherapy, Faculty of Science, Utrecht University, Utrecht, The Netherlands.
Drug Saf. 2010 Mar 1;33(3):233-44. doi: 10.2165/11319030-000000000-00000.
Studies on medication-related hospitalizations differ in study setting, studied population, outcome, and method of data collection. Thus, extrapolations based on a meta-analysis of unselected studies may be biased.
To explore the influence of study characteristics on the prevalence of medication-related hospitalizations.
After a structured literature search, the retrieved studies were categorized based on the following aspects: (i) study setting (e.g. all hospital admissions vs only acute hospital admissions); (ii) study population (e.g. an entire hospital, study ward(s), selected population and/or age group); (iii) outcome of medication-related problem (e.g. adverse drug reaction [ADR] vs adverse drug event [ADE]); (iv) method of data collection (e.g. medical chart review, spontaneous reporting or database research); and (v) continent in which the study took place (only for studies looking at all acute admissions). We then examined the relationship between these factors and reported prevalence of medication-related hospital admissions.
Ninety-five studies were analysed, with a range of reported prevalence of medication-related hospitalizations from 0.1% to 54%. Higher prevalences were found in the studies examining all hospital admissions than in the studies examining only acute hospital admissions. In addition, higher prevalences were found in the elderly population than in children. As would be expected, higher prevalences were also found in studies examining ADEs than in studies examining only ADRs. With respect to the method of data collection, medical chart screening resulted in higher prevalences of medication-related hospitalizations than database methods or spontaneous reporting. Combined studies in Europe show lower prevalences of medication-related hospital admissions than in other continents included in the study.
The reported prevalence of medication-related hospital admissions varies as a function of the setting (all admissions or only acute admissions), studied population (entire hospital, specific wards, selected population and age group), outcome (ADR/ADE), the method of data collection and the continent in which the study is performed.
Extrapolation using national hospital admission data and the prevalence identified by pooling international studies should be carried out with great caution.
药物相关住院治疗的研究在研究环境、研究人群、结局和数据收集方法上存在差异。因此，基于未选择的研究进行荟萃分析的推断可能存在偏倚。
探讨研究特征对药物相关住院率的影响。
在进行结构化文献检索后，根据以下方面对检索到的研究进行分类：（i）研究环境（例如所有住院患者与仅急性住院患者）；（ii）研究人群（例如整个医院、研究病房、选择的人群和/或年龄组）；（iii）药物相关问题的结局（例如药物不良反应[ADR]与药物不良事件[ADE]）；（iv）数据收集方法（例如病历回顾、自发报告或数据库研究）；以及（v）研究开展的大陆（仅适用于所有急性入院的研究）。然后，我们检查了这些因素与报告的药物相关住院率之间的关系。
分析了 95 项研究，报告的药物相关住院率范围为 0.1%至 54%。与仅急性住院患者相比，所有住院患者的研究中发现的住院率更高。此外，在老年人群中发现的住院率更高。与仅检查 ADR 的研究相比，在检查 ADE 的研究中发现的住院率更高是意料之中的。就数据收集方法而言，与数据库方法或自发报告相比，病历筛查导致更高的药物相关住院率。与纳入研究的其他大陆相比，来自欧洲的综合研究显示出更低的药物相关住院率。
报告的药物相关住院率因设置（所有入院或仅急性入院）、研究人群（整个医院、特定病房、选择的人群和年龄组）、结局（ADR/ADE）、数据收集方法以及研究开展的大陆而异。
使用国家住院数据和通过国际研究汇总确定的患病率进行外推应谨慎进行。
