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药物相关住院再入院的患病率和可预防率:系统评价。

Prevalence and Preventability of Drug-Related Hospital Readmissions: A Systematic Review.

机构信息

Department of Hospital Pharmacy, OLVG, Amsterdam, The Netherlands.

Department of Pharmacy, SintMaartenskliniek, Nijmegen, The Netherlands.

出版信息

J Am Geriatr Soc. 2018 Mar;66(3):602-608. doi: 10.1111/jgs.15244. Epub 2018 Feb 22.

DOI:10.1111/jgs.15244
PMID:29468640
Abstract

OBJECTIVES

To summarize the evidence on the prevalence and preventability of drug-related hospital readmissions.

DESIGN

A systematic review was performed of studies that examined drug-related hospital readmissions. PubMed, EMBASE, and the Cochrane Library were searched from inception through August 2016. Reference lists and a citation analysis on Web of Science and Scopus were also consulted. Two reviewers extracted study data with dual assessment of risk of bias. Prevalence and preventability of readmission due to drugs were calculated. Data were qualitatively summarized according to outcome.

RESULTS

Nineteen studies met the eligibility criteria. Nine measured readmissions due to drug-related problems, seven due to adverse drug reactions, two due to adverse drug events, and one due to drug-drug interactions. Rates of readmissions due to drugs varied from 3% to 64% (median 21%, interquartile range (IQR) 14-23%). Readmissions were deemed preventable in 5% to 87% of cases (median 69%, IQR 19-84%). Evidence regarding the risk factors for drug-related readmissions and drugs causing these readmissions was inconsistent.

CONCLUSION

Although studies show high variability in prevalence and preventability of drug-related hospital readmissions, readmissions due to drugs seem to occur often, especially in older adults. Further research is needed to specify the causes of preventable readmissions and implement effective interventions to reduce medication-related hospital admissions.

摘要

目的

总结药物相关医院再入院的发生率和可预防率的证据。

设计

对研究药物相关医院再入院的研究进行系统评价。检索了 PubMed、EMBASE 和 Cochrane Library 从建库到 2016 年 8 月的数据。还查阅了 Web of Science 和 Scopus 上的参考文献列表和引文分析。两位审查员使用双重风险评估方法提取研究数据。计算了药物相关再入院的发生率和可预防率。根据结果对数据进行定性总结。

结果

19 项研究符合入选标准。9 项研究测量了药物相关问题导致的再入院,7 项研究测量了药物不良反应导致的再入院,2 项研究测量了药物不良事件导致的再入院,1 项研究测量了药物相互作用导致的再入院。药物导致的再入院率从 3%到 64%不等(中位数 21%,四分位距 14-23%)。5%到 87%的再入院被认为是可预防的(中位数 69%,四分位距 19-84%)。关于药物相关再入院的危险因素和导致这些再入院的药物的证据不一致。

结论

尽管研究显示药物相关医院再入院的发生率和可预防率存在很大差异,但药物导致的再入院似乎经常发生,尤其是在老年人中。需要进一步研究以确定可预防再入院的原因,并实施有效的干预措施来减少与药物相关的住院。

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