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Record W2513912130 · doi:10.4212/cjhp.v69i4.1583

Patient Characteristics Associated with Adverse Drug Events in Hospital: An Overview of Reviews

2016· review· en· W2513912130 on OpenAlexaffvenue
Silvija Mihajlovic, Jeremie Gauthier, Erika MacDonald

Bibliographic record

VenueThe Canadian Journal of Hospital Pharmacy · 2016
Typereview
Languageen
FieldHealth Professions
TopicPatient Safety and Medication Errors
Canadian institutionsOttawa HospitalUniversity of Waterloo
Fundersnot available
KeywordsMedicinePolypharmacyMEDLINESystematic reviewGrey literatureData extractionAdverse effectFamily medicinePediatricsInternal medicine

Abstract

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<p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Adverse drug events (ADEs) occurring in hospital inpatients can have serious implications. The ability to identify and prioritize patients at higher risk of ADEs could help pharmacists to optimize their impact as members of the patient care team.</p><p><strong>Objective:</strong> To identify risk factors, patient characteristics, and medications associated with a higher likelihood of ADEs in adult inpatients through an overview of reviews on this topic.</p><p><strong>Data Sources:</strong> Systematic reviews and narrative reviews or guidelines identified through a search of MEDLINE and the Cochrane Database of Systematic Reviews (limited to articles published from 1995 to June 4, 2015), as well as a grey literature search.</p><p><strong>Study Selection and Data Extraction:</strong> For inclusion in this overview, a review had to discuss patient characteristics or risk factors associated with ADEs, medications associated with ADEs, or drug–drug interactions associated with ADEs, in adult inpatients. Articles retrieved by the literature search were screened for eligibility by a single reviewer.</p><p><strong>Data Synthesis:</strong> Eleven articles were deemed eligible for inclusion in this overview: 4 systematic reviews and 7 narrative reviews or guidelines. Their results were described narratively. Older age and polypharmacy were the most frequently cited risk factors associated with ADEs in hospital inpatients. Renal impairment, female sex, and decline in cognition were also frequently reported as being associated with ADEs. Medication classes reported to be associated with ADEs during the hospital stay included anticoagulants, anti-infectives/antibiotics, antidiabetic agents, analgesics (including opioids and nonsteroidal anti-inflammatory drugs), and cardiovascular drugs (including antihypertensive agents, diuretics, and digoxin). Two publications reported on preventable ADEs in hospital inpatients; the medications associated with preventable ADEs were consistent with those reported above.</p><p><strong>Conclusions:</strong> The risk factors, patient characteristics, and medication classes highlighted in this overview may help clinicians to prioritize patient populations who may be at higher risk of ADEs.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte :</strong> Les événements indésirables liés aux médicaments (EIM) touchant les patients hospitalisés peuvent avoir de graves conséquences. La capacité d’identifier les patients qui présentent un haut risque d’EIM et de les prioriser pourrait aider les pharmaciens à optimiser l’influence qu’ils exercent comme membres de l’équipe de soins aux patients.</p><p><strong>Objectif :</strong> Identifier les facteurs de risque, les caractéristiques des patients ou les médicaments associés à un potentiel plus élevé d’EIM chez les patients adultes hospitalisés à l’aide d’une synthèse des comptes rendus sur le sujet.</p><p><strong>Sources des données :</strong> Des analyses systématiques et des revues narratives ou des lignes directrices trouvées à l’aide d’une recherche dans MEDLINE et la Cochrane Database of Systematic Reviews (se limitant aux articles publiés entre 1995 et le 4 juin 2015) et d’une recherche dans la littérature grise.</p><p><strong>Sélection des études et extraction des données :</strong> Afin d’être admissible à la présente synthèse, un compte rendu devait aborder les caractéristiques des patients ou les facteurs de risque associés aux EIM, les médicaments associés aux EIM ou les interactions médicament médicament associées aux EIM chez le patient adulte hospitalisé. L’admissibilité des articles trouvés grâce à la recherche documentaire n’a été évaluée que par une seule personne.</p><p><strong>Synthèse des données :</strong> Les résultats des comptes rendus retenus ont été décrits de manière narrative. Onze articles ont été admis dans la présente synthèse : quatre analyses systématiques et sept revues narratives ou lignes directrices. L’âge avancé et la polypharmacie représentaient les facteurs de risque associés aux EIM les plus souvent mentionnés chez le patient adulte hospitalisé. L’insuffisance rénale, le sexe féminin et le déclin cognitif étaient eux aussi fréquemment indiqués comme étant des facteurs liés aux EIM. Parmi les classes de médicaments signalées comme étant associées aux EIM pendant le séjour à l’hôpital, on comptait : les anticoagulants, les anti-infectieux et les antibiotiques, les antidiabétiques, les analgésiques (notamment les opioïdes et les anti-inflammatoires non stéroïdiens) et les agents cardiovasculaires (notamment les antihypertenseurs, les diurétiques et la digoxine). Deux publications abordaient les EIM évitables chez le patient hospitalisé; les médicaments associés aux EIM faisaient partie de ceux mentionnés ci-dessus.</p><p><strong>Conclusion :</strong> Connaître les facteurs de risque, les caractéristiques des patients et les classes de médicaments mis en évidence dans la présente synthèse peut aider les cliniciens à accorder la priorité aux populations de patients qui pourraient présenter un plus grand risque d’EIM.</p>

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.902
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0000.002
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.143
GPT teacher head0.448
Teacher spread0.305 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations18
Published2016
Admission routes2
Has abstractyes

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