Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia.
Drug Saf. 2022 Mar;45(3):249-257. doi: 10.1007/s40264-021-01144-1. Epub 2022 Jan 28.
INTRODUCTION: Medication-related problems often lead to patient harm. This paper aims to review the Australian literature to determine the overall incidence, severity and preventability of medication-related hospital admissions, as well as providing a national estimate on their extent and cost. METHODS: The first part of the paper includes a literature search to identify studies that provided estimates of medication-related problems that caused hospital admissions. Incidence of medication-related hospital admissions, type of medication-related problem contributing to admission (e.g. adverse medicine reaction) and method used to estimate incidence (e.g. chart review) were extracted. Data on severity and preventability of the admissions were extracted where available. The second part of the paper involves use of methodological triangulation to estimate the extent and cost of medication-related hospital admission. Median estimates used to assess medication-related hospital admissions and the 2019-2020 national hospital admissions data were used to calculate the national estimate on the extent of medication-related hospital admission. Costs were also estimated. RESULTS: Seventeen studies provided estimates on the extent of medication-related hospital admissions as assessed using medication chart review. The median incidence of 2.5% (interquartile range [IQR] 0.6%) as a proportion of all hospital admissions suggests 275,000 hospital admissions annually in Australia are medication related. The median incidence of 9% (IQR 3.9%) of emergency admissions suggests that 270,000 admissions annually are medication related. Eight studies provided estimates of the extent of medication-related hospital admissions identified from administrative health data; the median incidence of 1.7% with an under-reporting rate of 82% suggests 280,000 hospital admissions annually are medication related. Triangulation of results suggests that at least 250,000 hospital admissions annually in Australia are medication related, with an estimated cost of 1.4 billion Australian dollars (AUD$). Five studies assessed severity, and nine studies assessed preventability. Preventability estimates suggest two-thirds of medication-related hospital admissions are potentially preventable. CONCLUSIONS: We estimated that 250,000 hospital admissions in Australia are medication related, with an annual cost of AUD$1.4 billion to the healthcare system. Two-thirds of medication-related hospital admissions are potentially preventable.
简介：药物相关问题常常导致患者受到伤害。本文旨在综述澳大利亚文献，以确定药物相关住院的总体发生率、严重程度和可预防程度，并对其程度和成本进行全国估计。
方法：本文的第一部分包括文献检索，以确定提供导致住院的药物相关问题发生率估计的研究。提取药物相关住院的发生率、导致入院的药物相关问题类型（例如药物不良反应）以及用于估计发生率的方法（例如图表审查）。在有数据的情况下，提取入院严重程度和可预防程度的数据。本文的第二部分涉及使用方法学三角测量来估计药物相关住院的程度和成本。使用评估药物相关住院的中位数估计值和 2019-2020 年全国住院数据来计算药物相关住院的全国估计值。还估计了成本。
结果：17 项研究提供了使用药物图表审查评估的药物相关住院程度的估计值。所有住院患者中 2.5%（四分位距[IQR]0.6%）的中位发生率表明，澳大利亚每年有 27.5 万例住院与药物相关。9%（IQR3.9%）的紧急入院中位发生率表明，每年有 27 万例住院与药物相关。8 项研究提供了从医疗保健行政数据中识别的药物相关住院程度的估计值；中位发生率为 1.7%，漏报率为 82%，表明澳大利亚每年有 28 万例住院与药物相关。结果的三角测量表明，澳大利亚每年至少有 25 万例住院与药物相关，估计医疗系统成本为 14 亿澳元（AUD$）。五项研究评估了严重程度，九项研究评估了可预防程度。可预防程度的估计表明，三分之二的药物相关住院是可以预防的。
结论：我们估计澳大利亚有 25 万例住院与药物相关，医疗系统每年为此花费 14 亿澳元。三分之二的药物相关住院是可以预防的。
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