Abstract
Background: Drug-related problems (DRPs) are recognised by the World Health Organisation as a global health challenge. Knowledge about risk factors (RFs) for DRPs aid in identifying and developing interventions to reduce the incidence of DRPs. However, little is known about such factors in mental health inpatient units.
Aim: To identify from the published literature the RFs for DRPs in hospital-based mental health units and to understand the type and extent of relationship between each risk factor and DRP.
Methods: Searches were run in MEDLINE, EMBASE, Web of Science, IPA, PsycINFO, and CINAHL PLUS from 1 January 2000 to 10 September 2021 to identify relevant quantitative studies that explored RFs for DRPs in adults hospitalised in mental health inpatient units. Reference lists of relevant reviews and included studies were searched manually to identify additional studies. Studies were excluded if they focused on outpatients, utilised incident reports, or focused on a specific medication or DRP subtype. Data were extracted independently by two of the authors and quality assessment was performed using the criteria developed by Allan and Barker.1
Results: Twenty-two studies met the inclusion criteria. Of these, eight (8/22, 36%) focused on potentially inappropriate prescribing, seven on medication errors, three on adverse drug reactions, one on adverse drug events, two on medication discrepancies, and two included a broader range of DRPs. Most of the studies (19/22, 86.4%) originated in Europe and 13 (59%) used logistic regression to identify the RFs. Several factors were found to increase the risk of DRPs in mental health inpatient units such as increased number of prescribed medications, length of hospitalisation, and prescriptions written by more senior prescriber grades. On the other hand, some protective factors were also identified such as a diagnosis of dementia. Identified RFs differed across the investigated types of DRPs, with for example advanced age found to be a risk factor for medication discrepancies but protective factor against potentially inappropriate prescribing. Patient gender, age, and the number of prescribed medications were the most investigated RFs (n = 14/22). However, most studies failed to find statistically significant association between patient gender or age and DRPs (Gender: 13/14, Age: 10/14).
Conclusion: This review identified a variety of patient, medication, and hospital-related RFs for DRPs in mental health inpatient units. These factors could aid in developing a screening tool to highlight patients at higher risk of DRPs in mental health inpatient units for intervention. Future research could focus on evaluating a wider range of possible factors associated with DRPs using standardised approaches.
REFERENCE
Allan EL, Barker KN. Fundamentals of medication error research. Am J Hosp Pharm, 1990;47(3):555–571.
Aim: To identify from the published literature the RFs for DRPs in hospital-based mental health units and to understand the type and extent of relationship between each risk factor and DRP.
Methods: Searches were run in MEDLINE, EMBASE, Web of Science, IPA, PsycINFO, and CINAHL PLUS from 1 January 2000 to 10 September 2021 to identify relevant quantitative studies that explored RFs for DRPs in adults hospitalised in mental health inpatient units. Reference lists of relevant reviews and included studies were searched manually to identify additional studies. Studies were excluded if they focused on outpatients, utilised incident reports, or focused on a specific medication or DRP subtype. Data were extracted independently by two of the authors and quality assessment was performed using the criteria developed by Allan and Barker.1
Results: Twenty-two studies met the inclusion criteria. Of these, eight (8/22, 36%) focused on potentially inappropriate prescribing, seven on medication errors, three on adverse drug reactions, one on adverse drug events, two on medication discrepancies, and two included a broader range of DRPs. Most of the studies (19/22, 86.4%) originated in Europe and 13 (59%) used logistic regression to identify the RFs. Several factors were found to increase the risk of DRPs in mental health inpatient units such as increased number of prescribed medications, length of hospitalisation, and prescriptions written by more senior prescriber grades. On the other hand, some protective factors were also identified such as a diagnosis of dementia. Identified RFs differed across the investigated types of DRPs, with for example advanced age found to be a risk factor for medication discrepancies but protective factor against potentially inappropriate prescribing. Patient gender, age, and the number of prescribed medications were the most investigated RFs (n = 14/22). However, most studies failed to find statistically significant association between patient gender or age and DRPs (Gender: 13/14, Age: 10/14).
Conclusion: This review identified a variety of patient, medication, and hospital-related RFs for DRPs in mental health inpatient units. These factors could aid in developing a screening tool to highlight patients at higher risk of DRPs in mental health inpatient units for intervention. Future research could focus on evaluating a wider range of possible factors associated with DRPs using standardised approaches.
REFERENCE
Allan EL, Barker KN. Fundamentals of medication error research. Am J Hosp Pharm, 1990;47(3):555–571.
| Original language | English |
|---|---|
| Title of host publication | Prescribing and Research in Medicines Management — PRIMM 33rd Annual Scientific Meeting |
| Pages | 11-12 |
| DOIs | |
| Publication status | Published - 1 Aug 2022 |