Related Experiment Video
Updated: May 1, 2026
Drug Repurposing Hypothesis Generation Using the "RE:fine Drugs" System
Published on: December 11, 2016
Identifying high-risk medication: a systematic literature review
Eva A Saedder1, Birgitte Brock, Lars Peter Nielsen
1Department of Clinical Pharmacology, Aarhus University Hospital, Wilhelm Meyers Allé 4, 8000, Aarhus C, Denmark, ea@farm.au.dk.
Purpose:
A medication error (ME) is an error that causes damage or poses a threat of harm to a patient. Several studies have shown that only a minority of MEs actually causes harm, and this might explain why medication reviews at hospital admission reduce the number of MEs without showing an effect on length of hospital stay, readmissions, or death. The purpose of this study was to define drugs that actually cause serious MEs. We conducted a literature search of medication reviews and other preventive efforts.
Methods:
A systematic search in PubMed, Embase, Cochrane Reviews, Psycinfo, and SweMed+ was performed. Danish databases containing published patient complaints, patient compensation, and reported medication errors were also searched. Articles and case reports were included if they contained information of an ME causing a serious adverse reaction (AR) in a patient. Information concerning AR seriousness, causality, and preventability was required for inclusion.
Results:
This systematic literature review revealed that 47 % of all serious MEs were caused by seven drugs or drug classes: methotrexate, warfarin, nonsteroidal anti-inflammatory drugs (NSAIDS), digoxin, opioids, acetylic salicylic acid, and beta-blockers; 30 drugs or drug classes caused 82 % of all serious MEs. The top ten drugs involved in fatal events accounted for 73 % of all drugs identified.
Conclusion:
Increasing focus on seven drugs/drug classes can potentially reduce hospitalizations, extended hospitalizations, disability, life-threatening conditions, and death by almost 50 %.
Insights
Focusing on seven specific drug classes, including methotrexate and warfarin, can significantly reduce serious medication errors and adverse events. This targeted approach has the potential to decrease hospitalizations and improve patient safety by nearly 50%.
Area of Science:
- Pharmacovigilance
- Patient Safety
- Drug Safety
Background:
- Medication errors (MEs) are frequent but often do not cause patient harm.
- Understanding which drugs cause serious MEs is crucial for targeted safety interventions.
- Previous efforts show medication reviews reduce MEs but not necessarily patient outcomes.
Purpose of the Study:
- To identify specific drugs and drug classes that are most frequently associated with serious medication errors.
- To provide evidence for prioritizing drug safety efforts.
Main Methods:
- Systematic literature review across multiple databases (PubMed, Embase, Cochrane, etc.).
- Inclusion of Danish databases for patient complaints and reported errors.
- Analysis of articles and case reports detailing MEs causing serious adverse reactions (ARs), requiring causality and preventability data.
Main Results:
- Seven drug classes (methotrexate, warfarin, NSAIDs, digoxin, opioids, aspirin, beta-blockers) accounted for 47% of serious MEs.
- A total of 30 drugs/classes caused 82% of serious MEs.
- The top ten drugs in fatal events comprised 73% of identified drugs.
Conclusions:
- Targeting interventions on these seven high-risk drug classes can substantially reduce severe patient harm.
- Focusing on these drugs may decrease hospitalizations, disability, and mortality by nearly 50%.
Related Concept Videos
01:24Drug Toxicity: Risk factors
01:15Drug Dosing: Geriatric Patients
01:26Pharmaceutical Poisoning: Potential Scenarios
01:12Hazard Ratio
For example, in a clinical trial...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion