Researchers from the University of Liverpool have found a growing trend in drug-related harm leading to hospitalisation.
This trend is due to the rising tide of multiple long-term health conditions (so-called multimorbidity) associated with the use of several medications at the same time (so-called polypharmacy).
This prospective observational study, led by researchers from the University of Liverpool and Bangor University, was carried out at University Hospitals Liverpool NHS Foundation Trust. This involved two doctors reviewing the medical records of 1,187 medical appointments during one month in 2019.
This changed the original research published by Professor Sir Munir Pirmohamed and colleagues from BMJ in 2004. At that time, it was found that 6.5% of hospitalizations were related to adverse drug reactions (ADRs). This updated figure shows a significant increase in this burden, which has risen to 16.5% of admissions caused or complicated by an adverse drug reaction.
Polypharmacy is usually defined as taking five or more common medications. The researchers determined that those who suffered adverse reactions were, on average, taking more medications and had more comorbidities than people without adverse reactions.
Polypharmacy can become difficult for patients, especially when it occurs in the context of overprescribing, that is, when people are given medications that they do not need or need, or that may harm them. Over the past 25 years, the number of overprescriptions has increased dramatically. This was highlighted in a recent NHS report on overprescribing, which claimed that 10% of prescriptions (around 110 million) should not have been written.
This updated research confirms that the problem is growing and that a system-wide approach is needed to address the societal, systemic, and cultural causes of overprescribing.
Dr Rostam Osanlu, specialist registrar in clinical pharmacology, said: “Our work shows that adverse drug reactions are a significant burden on patients and hospital admissions. This is associated with high costs to the NHS (over £2 billion a year ) and further efforts in this area could both improve patient care and save money for the NHS.”
Dr Lauren Walker, senior clinical lecturer at the University of Liverpool, said: “It is important that patients report any side effects to medicines to the MHRA through the yellow card system. It is important for patients to discuss any side effects with their healthcare provider and they should not stop taking medicines on their own desires”.
Professor Sir Munir Pirmohamed, David Wetherall Chair of Medicine, said: “Our updated analysis highlights the continuing burden placed on patients and the NHS by adverse drug reactions. There is no single, simple solution to prevent this and therefore a multi-layered an approach ranging from learning to improve appointments to the use of technology. This would be in line with the aims of the NHS’s long-term plan.”
The researchers’ analysis suggests that the annual cost of adverse reactions leading to hospital admissions is at least £2bn. A concerted national effort, beyond that described in the NHS report on overprescribing, is needed to improve the benefit-risk balance of prescribed medicines and thereby reduce the burden of adverse reactions on patients and health services.
Materials provided University of Liverpool. Note: Content can be edited for style and length.