Preventable drug-related morbidity in primary care part I - Impact of preventable drug-related morbidity

Abstract

Objective: To review the evidence on the magnitude and implications of preventable drug-related morbidity in primary care. Methods: Multiple formats were used to systematically search the literature on preventable drug-related morbidity (PDRM) in primary care. We looked for studies in adults examining avoidable morbidity caused by primary care usage of drugs. Nine electronic databases were searched and references of retrieved papers scanned. In an attempt to find Portuguese data we conducted a hand-search in a Portuguese journal and mailed requests to experts. Results: More than 100 articles were identified as potentially relevant. False positives included studies investigating inpatients and papers not providing quantitative estimates for preventability of drug-related morbidity. References that met our inclusion criteria were subsequently divided into reviews and original articles. Given the space available for this work original articles were excluded where relevant reviews had been published. Preventable drug-related hospital admissions are the most well studied issue (n=5 meta-analytic reviews), followed by preventable drugrelated emergency department visits (n=1 systematic review); little is known about preventable drug-related morbidity that is managed in primary care facilities (n=3 original studies). We found evidence that PDRM resulting in hospitalisation is a common problem; less serious drug-related injuries appear to be even more frequent.