High-risk medicines associated with clinically relevant medication-related problems in UK hospitals: A prospective observational study.

The aim of this prospective observational study was to establish associations between the use of high-risk medicine groups and the study outcome: occurrence of at least 1 moderate or severe preventable medication-related problem. Data on medication-related problems, high-risk medicines, and other potential risk factors were collected from adults on medical wards in 2 UK hospitals. Logistic regression modelling was used to determine relationships between high-risk medicines and the study outcome. Among 1503 eligible admissions, 6 high-risk medicine groups were associated with the study outcome on univariable analysis; multivariable analysis found only systemic antimicrobials and epilepsy medicines to be independently associated with the outcome (adjusted odds ratio 1.44, 95% confidence interval 1.08-1.92 and adjusted odds ratio 1.61, 95% confidence interval 1.16-2.25 respectively). Identification of high-risk medicine groups has potential to permit targeting of patients at highest risk of avoidable medication-related harm, but multivariable analysis suggests risk is likely to be multifactorial.