Researchers at the University of Liverpool have identified a growing trend of medicine-related harm leading to hospitalization.
The trend is linked to a rising tide of multiple long-term health conditions (called multimorbidity) associated with the simultaneous use of many drugs (called polypharmacy).
This prospective observational study by researchers from the University of Liverpool and Bangor University was undertaken at Liverpool University Hospitals NHS Foundation Trust. This was a review by two physicians of medical notes from 1,187 medical admissions over a one-month period in 2019.
It was an update of the original seminal study published by Professor Sir Munir Pirmohamed and his colleagues from BMJ in 2004. At that time, 6.5% of hospital admissions were found to be associated with adverse drug reactions (ADRs). This updated figure identifies a significant increase in this burden, rising to 16.5% of admissions caused or complicated by an adverse drug reaction.
Polypharmacy is generally defined as taking five or more regular medications. The researchers identified that those who suffered an adverse reaction took more medication on average and suffered from more comorbidities than those who did not have an adverse reaction.
Polypharmacy can become a burden on patients, especially when it occurs in the context of over-prescription, i.e. when people are given drugs they do not need or want not, or which may be harmful to them. Overprescribing has increased dramatically over the past 25 years. This was highlighted in a recent NHS report on over-prescribing which stated that 10% of prescriptions (around 110 million) should not have been dispensed.
This updated study confirms that the problem is worsening and that a comprehensive systems approach is needed to address the societal, systemic and cultural drivers of overprescribing.
Clinical Pharmacology Registrar Dr Rostam Osanlou said: “Our work suggests that adverse drug reactions place a significant burden on patients and hospital admissions. This has a significant associated cost to the NHS (over £2bn a year) and further efforts in this area might both improve patient care and save the NHS money. »
Dr Lauren Walker, Clinical Lecturer at the University of Liverpool, said: “It is important that patients report any adverse reactions to the MHRA through the yellow card system. It is important that patients discuss any side effects with their healthcare professional, and they should not stop medication on their own. »
Professor Sir Munir Pirmohamed, David Weatherall Professor of Medicine, said: “Our updated analysis highlights the continuing burden placed on patients and the NHS by adverse drug reactions. There is no simple, one-size-fits-all solution to prevent this, and so a multi-level approach, from education on better prescribing to the use of technology is needed. This would be in line with the objectives of the NHS long-term plan.
The researchers’ analysis suggests that the annual cost of adverse events resulting in hospitalization is at least £2 billion. A concerted national effort, beyond those outlined in the NHS Overprescription Report, is needed to improve the benefit-risk balance of prescribed medicines, and thereby reduce the burden of adverse effects on patients and healthcare services.
Source of the story:
Material provided by University of Liverpool. Note: Content may be edited for style and length.
