Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.

<h4>Background</h4>Adverse drug reactions (ADRs) represent a major cause of iatrogenic morbidity and mortality in patient care. While a substantial body of work has been undertaken to characterise ADRs in the hospital setting, the overall burden of ADRs in the primary care remains unclea...

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Autores principales:	Widya N Insani, Cate Whittlesea, Hassan Alwafi, Kenneth K C Man, Sarah Chapman, Li Wei
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0e81d2ae7f6d4e4ea9d3eeae3c571b02
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spelling	oai:doaj.org-article:0e81d2ae7f6d4e4ea9d3eeae3c571b022021-12-02T20:05:29ZPrevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.1932-620310.1371/journal.pone.0252161https://doaj.org/article/0e81d2ae7f6d4e4ea9d3eeae3c571b022021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252161https://doaj.org/toc/1932-6203<h4>Background</h4>Adverse drug reactions (ADRs) represent a major cause of iatrogenic morbidity and mortality in patient care. While a substantial body of work has been undertaken to characterise ADRs in the hospital setting, the overall burden of ADRs in the primary care remains unclear.<h4>Objectives</h4>To investigate the prevalence of ADRs in the primary care setting and factors affecting the heterogeneity of the estimates.<h4>Methods</h4>Studies were identified through searching of Medline, Embase, CINAHL and IPA databases. We included observational studies that reported information on the prevalence of ADRs in patients receiving primary care. Disease and treatment specific studies were excluded. Quality of the included studies were assessed using Smyth ADRs adapted scale. A random-effects model was used to calculate the pooled estimate. Potential source of heterogeneity, including age groups, ADRs definitions, ADRs detection methods, study setting, quality of the studies, and sample size, were investigated using sub-group analysis and meta-regression.<h4>Results</h4>Thirty-three studies with a total study population of 1,568,164 individuals were included. The pooled prevalence of ADRs in the primary care setting was 8.32% (95% CI, 7.82, 8.83). The percentage of preventable ADRs ranged from 12.35-37.96%, with the pooled estimate of 22.96% (95% CI, 7.82, 38.09). Cardiovascular system drugs were the most commonly implicated medication class. Methods of ADRs detection, age group, setting, and sample size contributed significantly to the heterogeneity of the estimates.<h4>Conclusion</h4>ADRs constitute a significant health problem in the primary care setting. Further research should focus on examining whether ADRs affect subsequent clinical outcomes, particularly in high-risk therapeutic areas. This information may better inform strategies to reduce the burden of ADRs in the primary care setting.Widya N InsaniCate WhittleseaHassan AlwafiKenneth K C ManSarah ChapmanLi WeiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0252161 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Widya N Insani Cate Whittlesea Hassan Alwafi Kenneth K C Man Sarah Chapman Li Wei Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.
description	<h4>Background</h4>Adverse drug reactions (ADRs) represent a major cause of iatrogenic morbidity and mortality in patient care. While a substantial body of work has been undertaken to characterise ADRs in the hospital setting, the overall burden of ADRs in the primary care remains unclear.<h4>Objectives</h4>To investigate the prevalence of ADRs in the primary care setting and factors affecting the heterogeneity of the estimates.<h4>Methods</h4>Studies were identified through searching of Medline, Embase, CINAHL and IPA databases. We included observational studies that reported information on the prevalence of ADRs in patients receiving primary care. Disease and treatment specific studies were excluded. Quality of the included studies were assessed using Smyth ADRs adapted scale. A random-effects model was used to calculate the pooled estimate. Potential source of heterogeneity, including age groups, ADRs definitions, ADRs detection methods, study setting, quality of the studies, and sample size, were investigated using sub-group analysis and meta-regression.<h4>Results</h4>Thirty-three studies with a total study population of 1,568,164 individuals were included. The pooled prevalence of ADRs in the primary care setting was 8.32% (95% CI, 7.82, 8.83). The percentage of preventable ADRs ranged from 12.35-37.96%, with the pooled estimate of 22.96% (95% CI, 7.82, 38.09). Cardiovascular system drugs were the most commonly implicated medication class. Methods of ADRs detection, age group, setting, and sample size contributed significantly to the heterogeneity of the estimates.<h4>Conclusion</h4>ADRs constitute a significant health problem in the primary care setting. Further research should focus on examining whether ADRs affect subsequent clinical outcomes, particularly in high-risk therapeutic areas. This information may better inform strategies to reduce the burden of ADRs in the primary care setting.
format	article
author	Widya N Insani Cate Whittlesea Hassan Alwafi Kenneth K C Man Sarah Chapman Li Wei
author_facet	Widya N Insani Cate Whittlesea Hassan Alwafi Kenneth K C Man Sarah Chapman Li Wei
author_sort	Widya N Insani
title	Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.
title_short	Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.
title_full	Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.
title_fullStr	Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.
title_full_unstemmed	Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.
title_sort	prevalence of adverse drug reactions in the primary care setting: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/0e81d2ae7f6d4e4ea9d3eeae3c571b02
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Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.

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