{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T07:18:09Z","timestamp":1794035889181,"version":"4.8.0"},"reference-count":61,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002347","name":"German Federal Ministry of Education and Research","doi-asserted-by":"publisher","award":["01ZZ1910L"],"award-info":[{"award-number":["01ZZ1910L"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Adverse drug events (ADEs) and adverse drug reactions (ADRs) are leading causes of iatrogenic injury, which can result in emergency department (ED) visits or admissions to inpatient wards. The aim of this systematic review and meta-analysis was to provide up-to-date estimates of the prevalence of (preventable) drug-related ED visits and hospital admissions, as well as the type and prevalence of implicated ADRs\/ADEs and drugs. A literature search of studies published between January 2012 and December 2021 was performed in PubMed, Medline, EMBASE, Cochrane Library, and Web of Science. Retrospective and prospective observational studies investigating acute admissions to EDs or inpatient wards due to ADRs or ADEs in the general population were included. Meta-analyses of prevalence rates were conducted using generalized linear mixed models (GLMM) with the random-effect method. Seventeen studies reporting ADRs and\/or ADEs were eligible for inclusion. The prevalence rates of ADR- and ADE-related admissions to EDs or inpatient wards were estimated at 8.3% ([95% CI, 6.4\u201310.7%]) and 13.9% ([95% CI, 8.1\u201322.8%]), respectively, of which almost half (ADRs: 44.7% [95% CI: 28.1; 62.4]) and more than two thirds (ADEs: 71.0% [95% CI, 65.9\u201375.6%]) had been classified as at least possibly preventable. The ADR categories most frequently implicated in ADR-related admissions were gastrointestinal disorders, electrolyte disturbances, bleeding events, and renal and urinary disorders. Nervous system drugs were found to be the most commonly implicated drug groups, followed by cardiovascular and antithrombotic agents. Our findings demonstrate that ADR-related admissions to EDs and inpatient wards still represent a major and often preventable health care problem. In comparison to previous systematic reviews, cardiovascular and antithrombotic drugs remain common causes of drug-related admissions, while nervous system drugs appear to have become more commonly implicated. These developments may be considered in future efforts to improve medication safety in primary care.<\/jats:p>","DOI":"10.3390\/jcm12041320","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T01:32:05Z","timestamp":1675819925000},"page":"1320","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Which Adverse Events and Which Drugs Are Implicated in Drug-Related Hospital Admissions? 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Medication without Harm. Available online: https:\/\/www.who.int\/initiatives\/medication-without-harm."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1002\/pds.2118","article-title":"Adverse drug reactions in Germany: Direct costs of internal medicine hospitalizations","volume":"20","author":"Rottenkolber","year":"2011","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_3","unstructured":"Bundesministerium f\u00fcr Gesundheit (2022, April 17). Aktionsplan 2021\u20132024 zur Verbesserung der Arzneimitteltherapiesicherheit in Deutschland. Available online: https:\/\/www.akdae.de\/AMTS\/Aktionsplan\/Aktionsplan-2021-2024\/Aktionsplan-AMTS-2021-2024.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1136\/bmj.329.7456.15","article-title":"Adverse drug reactions as cause of admission to hospital: Prospective analysis of 18 820 patients","volume":"329","author":"Pirmohamed","year":"2004","journal-title":"BMJ"},{"key":"ref_5","first-page":"251","article-title":"Adverse Drug Reactions (ADR) and Emergencies","volume":"115","author":"Schurig","year":"2018","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1365-2125.2006.02698.x","article-title":"Which drugs cause preventable admissions to hospital? A systematic review","volume":"63","author":"Howard","year":"2007","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1111\/bcp.12293","article-title":"A systematic review of hospitalization resulting from medicine-related problems in adult patients","volume":"78","author":"Ghaleb","year":"2014","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/14740338.2018.1415322","article-title":"Preventable ADRs leading to hospitalization\u2014Results of a long-term prospective safety study with 6,427 ADR cases focusing on elderly patients","volume":"17","author":"Schmiedl","year":"2018","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1345\/aph.1L037","article-title":"Hospital admissions associated with adverse drug reactions: A systematic review of prospective observational studies","volume":"42","author":"Kongkaew","year":"2008","journal-title":"Ann. Pharmacother."},{"key":"ref_10","first-page":"2079","article-title":"A systematic review of the prevalence and risk factors for adverse drug reactions in the elderly in the acute care setting","volume":"9","author":"Alhawassi","year":"2014","journal-title":"Clin. Interv. Aging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1345\/aph.1P627","article-title":"Prevalence of adverse drug events in ambulatory care: A systematic review","volume":"45","author":"Ashcroft","year":"2011","journal-title":"Ann. Pharmacother."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2165\/11319030-000000000-00000","article-title":"The relationship between study characteristics and the prevalence of medication-related hospitalizations: A literature review and novel analysis","volume":"33","author":"Leendertse","year":"2010","journal-title":"Drug Saf."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Brvar, M., Fokter, N., Bunc, M., and Mozina, M. (2009). The frequency of adverse drug reaction related admissions according to method of detection, admission urgency and medical department specialty. BMC Clin. Pharmacol., 9.","DOI":"10.1186\/1472-6904-9-8"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1111\/bcp.15012","article-title":"Methodological issues in research on drug-related admissions: A meta-epidemiological review with focus on causality assessments","volume":"88","author":"Wallerstedt","year":"2022","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"795","DOI":"10.7326\/0003-4819-140-10-200405180-00009","article-title":"Clarifying adverse drug events: A clinician\u2019s guide to terminology, documentation, and reporting","volume":"140","author":"Nebeker","year":"2004","journal-title":"Ann. Intern. Med."},{"key":"ref_16","unstructured":"(1972). International drug monitoring: The role of national centres. Report of a WHO meeting. World Health Organ. Tech. Rep. Ser., 498, 1\u201325."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/clpt.1981.154","article-title":"A method for estimating the probability of adverse drug reactions","volume":"30","author":"Naranjo","year":"1981","journal-title":"Clin. Pharmacol. Ther."},{"key":"ref_19","unstructured":"World Health Organization (WHO) (2022, April 17). The WHO-UMC System. Available online: https:\/\/www.who.int\/publications\/m\/item\/WHO-causality-assessment."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., G\u00f8tzsche, P.C., and Vandenbroucke, J.P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040296"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/biomet\/26.4.404","article-title":"The Use of Confidence or Fiducial Limits Illustrated in the Case of the Binomial","volume":"26","author":"Clopper","year":"1934","journal-title":"Biometrika"},{"key":"ref_22","unstructured":"(2022, April 17). WHO International Classification of Diseases, Version 10. Available online: https:\/\/icd.who.int\/browse10\/2019\/en."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"109","DOI":"10.2165\/00002018-199920020-00002","article-title":"The Medical Dictionary for Regulatory Activities (MedDRA)","volume":"20","author":"Brown","year":"1999","journal-title":"Drug Saf."},{"key":"ref_24","unstructured":"WHO Collaborating Centre for Drug Statistics Methodology (2022, April 17). ATC\/DDD Index. Available online: https:\/\/www.whocc.no\/atc_ddd_index\/."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1097\/EDE.0000000000001232","article-title":"Meta-analysis of Proportions Using Generalized Linear Mixed Models","volume":"31","author":"Lin","year":"2020","journal-title":"Epidemiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1136\/emermed-2012-201945","article-title":"Determining the frequency and preventability of adverse drug reaction-related admissions to an Irish University Hospital: A cross-sectional study","volume":"31","author":"Ahern","year":"2014","journal-title":"Emerg. Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3825","DOI":"10.1111\/bcp.14790","article-title":"Inter-rater reliability of assessments regarding the quality of drug treatment, and drug-related hospital admissions","volume":"87","author":"Holmqvist","year":"2021","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"734","DOI":"10.3389\/fphar.2020.00734","article-title":"Urgent Hospital Admissions Caused by Adverse Drug Reactions and Medication Errors-A Population-Based Study in Spain","volume":"11","author":"Ochoa","year":"2020","journal-title":"Front. Pharmacol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/s00228-013-1630-5","article-title":"Prevalence, risk factors and main features of adverse drug reactions leading to hospital admission","volume":"70","author":"Pedros","year":"2014","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Rydberg, D.M., Holm, L., Engqvist, I., Fryckstedt, J., Lindh, J.D., Stiller, C.-O., and Asker-Hagelberg, C. (2016). Adverse Drug Reactions in a Tertiary Care Emergency Medicine Ward\u2014Prevalence, Preventability and Reporting. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0162948"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"945","DOI":"10.3906\/sag-1503-14","article-title":"Emergency department visits caused by adverse drug reactions: Results of aTurkish university hospital","volume":"46","author":"Girgin","year":"2016","journal-title":"Turk. J. Med. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1111\/bcp.14304","article-title":"The phenotype of adverse drug effects: Do emergency visits due to adverse drug reactions look different in older people? Results from the ADRED study","volume":"86","author":"Just","year":"2020","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s00228-019-02797-9","article-title":"Personalising drug safety-results from the multi-centre prospective observational study on Adverse Drug Reactions in Emergency Departments (ADRED)","volume":"76","author":"Just","year":"2020","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e1040","DOI":"10.1097\/PTS.0000000000000679","article-title":"Adverse Drug Events Detected by Clinical Pharmacists in an Emergency Department: A Prospective Monocentric Observational Study","volume":"17","author":"Laureau","year":"2021","journal-title":"J. Patient Saf."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"192","DOI":"10.2174\/1574886314666190520105330","article-title":"Adverse Drug Reaction (ADR) as a Cause of Hospitalization at a Government Hospital in Saudi Arabia: A Prospective Observational Study","volume":"14","author":"Alayed","year":"2019","journal-title":"Curr. Drug Saf."},{"key":"ref_37","first-page":"169","article-title":"Medications Related Emergency Admissions: Causes and Recommendations","volume":"238","author":"Aldardeer","year":"2017","journal-title":"Stud. Health Technol. Inform."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1111\/bcp.13081","article-title":"Prevalence and characteristics of adverse drug reactions at admission to hospital: A prospective observational study","volume":"82","author":"Chan","year":"2016","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1002\/pds.5215","article-title":"Emergency hospitalizations for adverse drug events in China: Clinical pharmacists\u2019 approach to assessment and categorization","volume":"30","author":"Zhang","year":"2021","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/s40801-015-0045-2","article-title":"Prevalence of Drug-Related Emergency Department Visits at a Teaching Hospital in Malaysia","volume":"2","author":"Jatau","year":"2015","journal-title":"Drugs Real World Outcomes"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1080\/14740338.2021.1938539","article-title":"Prevalence, characteristics, and reporting of adverse drug reactions in an Australian hospital: A retrospective review of hospital admissions due to adverse drug reactions","volume":"20","author":"Li","year":"2021","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1071\/AH12027","article-title":"Hospital admissions caused by adverse drug events: An Australian prospective study","volume":"38","author":"Phillips","year":"2014","journal-title":"Aust. Health Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1111\/acem.13407","article-title":"Prospective Validation of Clinical Criteria to Identify Emergency Department Patients at High Risk for Adverse Drug Events","volume":"25","author":"Hohl","year":"2018","journal-title":"Acad. Emerg. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1002\/cpt1977213247","article-title":"Toward the operational identification of adverse drug reactions","volume":"21","author":"Karch","year":"1977","journal-title":"Clin. Pharmacol. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Gallagher, R.M., Kirkham, J.J., Mason, J.R., Bird, K.A., Williamson, P.R., Nunn, A.J., Turner, M.A., Smyth, R.L., and Pirmohamed, M. (2011). Development and inter-rater reliability of the Liverpool adverse drug reaction causality assessment tool. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0028096"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2515\/therapie\/2013016","article-title":"Updating the French method for the causality assessment of adverse drug reactions","volume":"68","author":"Arimone","year":"2013","journal-title":"Therapie"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/00003727-198208000-00009","article-title":"Adverse drug reactions in the community health setting: Approaches to recognizing, counseling, and reporting","volume":"5","author":"Jones","year":"1982","journal-title":"Fam. Community Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/j.1365-2796.1990.tb00199.x","article-title":"Drug related hospital admissions: The role of definitions and intensity of data collection, and the possibility of prevention","volume":"228","author":"Hallas","year":"1990","journal-title":"J. Intern. Med."},{"key":"ref_49","first-page":"538","article-title":"Focusing on the preventability of adverse drug reactions","volume":"27","author":"Schumock","year":"1992","journal-title":"Hosp. Pharm."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1046\/j.1445-5994.2001.00044.x","article-title":"Adverse drug events as a cause of hospital admission in the elderly","volume":"31","author":"Chan","year":"2001","journal-title":"Intern. Med. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1002\/j.1875-9114.1996.tb03658.x","article-title":"Drug-related hospital admissions","volume":"16","author":"Nelson","year":"1996","journal-title":"Pharmacotherapy"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/S0003-4509(05)82263-1","article-title":"Adverse drug effects: A prospective study by Apnet performed in seven emergency care units in France: Propositions for preventive measures","volume":"63","author":"Queneau","year":"2005","journal-title":"Ann. Pharm. Fr."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Hakkarainen, K.M., Hedna, K., Petzold, M., and H\u00e4gg, S. (2012). Percentage of patients with preventable adverse drug reactions and preventability of adverse drug reactions--a meta-analysis. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0033236"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s00228-016-2170-6","article-title":"Hospitalizations due to preventable adverse reactions-a systematic review","volume":"73","author":"Patel","year":"2017","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s40264-016-0444-7","article-title":"Adverse-Drug-Reaction-Related Hospitalisations in Developed and Developing Countries: A Review of Prevalence and Contributing Factors","volume":"39","author":"Angamo","year":"2016","journal-title":"Drug Saf."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"(2019). American Geriatrics Society 2019 Updated AGS Beers Criteria\u00ae for Potentially Inappropriate Medication Use in Older Adults. J. Am. Geriatr. Soc., 67, 674\u2013694.","DOI":"10.1111\/jgs.15767"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"72","DOI":"10.5414\/CPP46072","article-title":"STOPP (Screening Tool of Older Person\u2019s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation","volume":"46","author":"Gallagher","year":"2008","journal-title":"Int. J. Clin. Pharmacol. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1056\/NEJMsa1508955","article-title":"Safer Prescribing\u2014A Trial of Education, Informatics, and Financial Incentives","volume":"374","author":"Dreischulte","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1016\/S0140-6736(11)61817-5","article-title":"A pharmacist-led information technology intervention for medication errors (PINCER): A multicentre, cluster randomised, controlled trial and cost-effectiveness analysis","volume":"379","author":"Avery","year":"2012","journal-title":"Lancet"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1023\/A:1015570104121","article-title":"Hospitalisations caused by adverse drug reactions (ADR): A meta-analysis of observational studies","volume":"24","author":"Beijer","year":"2002","journal-title":"Pharm. World Sci."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1001\/jamainternmed.2014.949","article-title":"Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: The EMPOWER cluster randomized trial","volume":"174","author":"Tannenbaum","year":"2014","journal-title":"JAMA Intern. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/4\/1320\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:26:44Z","timestamp":1760120804000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/4\/1320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,7]]},"references-count":61,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jcm12041320"],"URL":"https:\/\/doi.org\/10.3390\/jcm12041320","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,7]]}}}