Observational studyBMJ open2022
Adverse drug reactions, multimorbidity and polypharmacy: a prospective analysis of 1 month of medical admissions.
Observational study in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 109 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
109 citing papers in PubMed, 10 syntheses or guidelines pooled it, 168 citations in OpenAlex.
- Economic evidence for licensed ready-to-administer intravenous products compared with standard vials and ampoules: a systematic review.Anaesthesia · 2026Pooled it
- The views of healthcare professionals and family members on deprescribing preventive medication in people living with dementia: a qualitative systematic review.BMC geriatrics · 2026Pooled it
- Economic effectiveness of pharmacogenomics-guided prescribing for psychiatric disorders: a systematic review and meta-analysis.The pharmacogenomics journal · 2026Pooled it
- Economic Evaluations of Medication Safety Interventions in Primary and Long-Term Care: A Systematic Review.PharmacoEconomics · 2026Pooled it
- Machine learning models for adverse drug reaction prediction. A systematic review and three-level multilevel meta-analysis.Frontiers in pharmacology · 2026Pooled it
- Bariatric Surgery and Remission of Metabolic Syndrome: A Meta-analysis of Randomised Controlled Trials and Prospective Studies.Obesity surgery · 2025Pooled it
- Nurse-Led Interventions to Improve Health, Adherence, and Functional Outcomes in Adults and Older Adults With Multimorbidity: A Systematic Review of Randomized and Quasiexperimental Studies.Journal of nursing management · 2025Pooled it
- Investigating pain-related medication use and contribution to polypharmacy in adults with intellectual disabilities: a systematic review.BMC medicine · 2024Pooled it
- Association of Drug-Disease Interactions with Mortality or Readmission in Hospitalised Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis.Drugs - real world outcomes · 2024Pooled it
- A systematic review of knowledge, attitude and practice of pharmacogenomics in pediatric oncology patients.Pharmacology research & perspectives · 2023Pooled it
- Trial
- Trial
- Perceptions and experiences of chair-based yoga by older adults with multimorbidity - a qualitative process evaluation of the Gentle Years Yoga randomised controlled trial.BMC geriatrics · 2025Trial
- Polypharmacy in Older Patients with Multimorbidity: The Agreement Between Patient and General Practitioner-Reported Drugs Observed in a Pilot cRCT.International journal of environmental research and public health · 2024Trial
- Real-World Safety of Fluticasone Furoate/Umeclidinium/Vilanterol in Patients with Asthma or Chronic Obstructive Pulmonary Disease (COPD), and Clinical Outcomes in COPD: Post-marketing Surveillance in Korea.Tuberculosis and respiratory diseases · 2026Article
- A SHAP-Informed Formal Feature Attribution Framework for Drug-Drug Interaction Risk in Large-Scale Claims Data.Clinical and translational science · 2026Article
- Intelligent Framework for Adverse Drug Event Identification Using Large Language Models and Retrieval-Augmented Generation: Development and Evaluation Study.Journal of medical Internet research · 2026Article
- Appropriateness over Numbers: Pharmacological Burden and Scalable Medication Review in Older Adults.Geriatrics (Basel, Switzerland) · 2026Review
- Prediction tools to prioritise hospitalised adult patients at risk of drug related problems: An umbrella review.PLOS digital health · 2026Article
- Impact of structured medication reviews on prescribing in English primary care: a retrospective observational cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Observational
49 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo ascertain the burden and associated cost of adverse drug reactions (ADRs), polypharmacy and multimorbidity through a prospective analysis of all medical admissions to a large university teaching hospital over a 1-month period.
designProspective observational study.
settingLiverpool University Hospital Foundation National Health Service (NHS) Trust, England.
participantsAll medical admissions with greater than 24-hour stay over a 1-month period.
main outcome measuresPrevalence of admissions due to an ADR and associated mortality, prevalence and association of multimorbidity and polypharmacy with ADRs, and estimated local financial cost of admissions where an ADR was a contributing or main reason for admission with projected costs for NHS in England.
resultsThere were 218 identified patient admissions with an ADR giving a prevalence of 18.4%. The majority of these (90.4%) were ADRs that directly resulted in or contributed to admission. ADRs thus accounted for 16.5% of total admissions. Those with an ADR were on average taking more medicines (10.5 vs 7.8, p<0.01) and had more comorbidities than those without an ADR (6.1 vs 5.2, p<0.01). Drugs most commonly implicated were diuretics, steroid inhalers, anticoagulants and antiplatelets, proton pump inhibitors, chemotherapeutic agents and antihypertensives. 40.4% of ADRs were classified avoidable or possibly avoidable. The mortality rate due to an ADR was 0.34%. The average length of stay for those with an ADR was 6 days. Direct 1-month cost to the Trust from ADR admissions was £490 716. Extrapolated nationally, the projected annual cost to the NHS in England is 2.21 billion.
conclusionThe local prevalence of admission and mortality from ADRs is higher than previously reported. Important factors that could be contributing to this include polypharmacy and multimorbidity. ADRs place a significant burden on patients and healthcare services with associated financial implications. Reducing inappropriate polypharmacy should be a major aim for preventing ADRs.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.