Identifying high-risk medication: a systematic literature review

Eva A Saedder, Birgitte Brock, Lars Peter Nielsen, Dorthe Krogsgaard Bonnerup, Marianne Lisby

103 Citations (Scopus)


PURPOSE: A medication error (ME) is an error that causes damage or poses a threat of harm to a patient. Several studies have shown that only a minority of MEs actually causes harm, and this might explain why medication reviews at hospital admission reduce the number of MEs without showing an effect on length of hospital stay, readmissions, or death. The purpose of this study was to define drugs that actually cause serious MEs. We conducted a literature search of medication reviews and other preventive efforts.

METHODS: A systematic search in PubMed, Embase, Cochrane Reviews, Psycinfo, and SweMed+ was performed. Danish databases containing published patient complaints, patient compensation, and reported medication errors were also searched. Articles and case reports were included if they contained information of an ME causing a serious adverse reaction (AR) in a patient. Information concerning AR seriousness, causality, and preventability was required for inclusion.

RESULTS: This systematic literature review revealed that 47 % of all serious MEs were caused by seven drugs or drug classes: methotrexate, warfarin, nonsteroidal anti-inflammatory drugs (NSAIDS), digoxin, opioids, acetylic salicylic acid, and beta-blockers; 30 drugs or drug classes caused 82 % of all serious MEs. The top ten drugs involved in fatal events accounted for 73 % of all drugs identified.

CONCLUSION: Increasing focus on seven drugs/drug classes can potentially reduce hospitalizations, extended hospitalizations, disability, life-threatening conditions, and death by almost 50 %.

Original languageEnglish
JournalEuropean Journal of Clinical Pharmacology
Issue number6
Pages (from-to)637-45
Number of pages9
Publication statusPublished - Jun 2014
Externally publishedYes


  • Adverse Drug Reaction Reporting Systems
  • Drug-Related Side Effects and Adverse Reactions
  • Hospitalization
  • Humans
  • Medication Errors
  • Pharmaceutical Preparations
  • Journal Article
  • Review


Dive into the research topics of 'Identifying high-risk medication: a systematic literature review'. Together they form a unique fingerprint.

Cite this