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Methods for identifying adverse drug reactions in primary care: A systematic review
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David Hughes,
Adam Turner ,
Neil Carter,
Sue Jordan
PLOS ONE, Volume: 20, Issue: 2, Start page: e0317660
Swansea University Authors:
David Hughes, Adam Turner , Neil Carter, Sue Jordan
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© 2025 Logan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License.
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DOI (Published version): 10.1371/journal.pone.0317660
Abstract
BackgroundIdentification of real-time adverse drug reactions [ADRs] (as opposed to the risk of ADRs) in older poly-medicated people in primary care is a challenging task, often undertaken without an explicit strategy. This systematic review aims to evaluate replicable instruments and methods for ide...
| Published in: | PLOS ONE |
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| ISSN: | 1932-6203 |
| Published: |
Public Library of Science (PLoS)
2025
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa68872 |
| Abstract: |
BackgroundIdentification of real-time adverse drug reactions [ADRs] (as opposed to the risk of ADRs) in older poly-medicated people in primary care is a challenging task, often undertaken without an explicit strategy. This systematic review aims to evaluate replicable instruments and methods for identifying and addressing ADRs.MethodsA systematic search was conducted in Medline, CINAHL, Scopus, Web of Science and Cochrane library, using controlled vocabulary (MeSH) and free-text terms. Randomised controlled trials (RCTs) implementing strategies to identify or resolve ADRs experienced by patients in primary care were included. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias tool. Discrepancies were resolved by discussion.ResultsFrom 2,182 unique records, 49 studies were identified for full review. Eight papers reporting results from 6 RCTs were included. All six trials utilised a list of medicine-related unwanted symptoms to identify ADRs. Two of three studies using adverse drug reaction questionnaires reported statistically significant increased rates of ADR reporting. Two of three studies that combined symptom questionnaires with prescriber consultations reported reductions in the number of health problems. Overall, results suggest that the three studies that described multidisciplinary collaborations using lists of ADRs plus prescriber reviews enhanced patient safety. However, the RCTs were unblinded and reported suboptimal retention. When considered as a whole, findings are equivocal and the data are too heterogenous to warrant any firm conclusions, beyond the need for more research to optimise strategies to safeguard patient wellbeing.ImplicationsAdaptable and scalable instruments with decision support are needed in primary care to identify and mitigate medicine-related harm in older poly-medicated people. The effectiveness of adverse drug reaction identification instruments, the value of comprehensive instruments, and the optimum method of delivery should be explored in multicentre trials. |
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| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This work was funded by Swansea University (Centenary Research Excellence Scholarship), sponsor reference RIO 034-20. |
| Issue: |
2 |
| Start Page: |
e0317660 |