Methods for identifying adverse drug reactions in primary care: A systematic review

Logan, Vera; Hughes, David; Turner, Adam; Carter, Neil; Jordan, Sue

doi:10.1371/journal.pone.0317660

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Methods for identifying adverse drug reactions in primary care: A systematic review

Vera Logan

, 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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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...

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Published in:	PLOS ONE
ISSN:	1932-6203
Published:	Public Library of Science (PLoS) 2025
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa68872

first_indexed	2025-02-11T18:09:33Z
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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. 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spelling	2025-03-26T12:34:05.7568337 v2 68872 2025-02-11 Methods for identifying adverse drug reactions in primary care: A systematic review f1fbd458e3c75d8b597c0ac8036f2b88 David Hughes David Hughes true false 486394f1fb20386cbf02509e4a70ddd4 0000-0002-0721-7662 Adam Turner Adam Turner true false 9a3f8cbd9ad25966c489e44fabed844f Neil Carter Neil Carter true false 24ce9db29b4bde1af4e83b388aae0ea1 Sue Jordan Sue Jordan true false 2025-02-11 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. Journal Article PLOS ONE 20 2 e0317660 Public Library of Science (PLoS) 1932-6203 4 2 2025 2025-02-04 10.1371/journal.pone.0317660 COLLEGE NANME COLLEGE CODE Swansea University Another institution paid the OA fee This work was funded by Swansea University (Centenary Research Excellence Scholarship), sponsor reference RIO 034-20. 2025-03-26T12:34:05.7568337 2025-02-11T18:06:52.4208463 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Vera Logan 0000-0001-7437-0272 1 David Hughes 2 Adam Turner 0000-0002-0721-7662 3 Neil Carter 4 Sue Jordan 5 68872__33886__efe9c17be264405cb1249ea476ded2a5.pdf 68872.VoR.pdf 2025-03-26T12:28:53.9823733 Output 1038162 application/pdf Version of Record true © 2025 Logan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title	Methods for identifying adverse drug reactions in primary care: A systematic review
spellingShingle	Methods for identifying adverse drug reactions in primary care: A systematic review David Hughes Adam Turner Neil Carter Sue Jordan
title_short	Methods for identifying adverse drug reactions in primary care: A systematic review
title_full	Methods for identifying adverse drug reactions in primary care: A systematic review
title_fullStr	Methods for identifying adverse drug reactions in primary care: A systematic review
title_full_unstemmed	Methods for identifying adverse drug reactions in primary care: A systematic review
title_sort	Methods for identifying adverse drug reactions in primary care: A systematic review
author_id_str_mv	f1fbd458e3c75d8b597c0ac8036f2b88 486394f1fb20386cbf02509e4a70ddd4 9a3f8cbd9ad25966c489e44fabed844f 24ce9db29b4bde1af4e83b388aae0ea1
author_id_fullname_str_mv	f1fbd458e3c75d8b597c0ac8036f2b88_*_David Hughes 486394f1fb20386cbf02509e4a70ddd4__Adam Turner 9a3f8cbd9ad25966c489e44fabed844f__Neil Carter 24ce9db29b4bde1af4e83b388aae0ea1_*_Sue Jordan
author	David Hughes Adam Turner Neil Carter Sue Jordan
author2	Vera Logan David Hughes Adam Turner Neil Carter Sue Jordan
format	Journal article
container_title	PLOS ONE
container_volume	20
container_issue	2
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institution	Swansea University
issn	1932-6203
doi_str_mv	10.1371/journal.pone.0317660
publisher	Public Library of Science (PLoS)
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description	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.
published_date	2025-02-04T05:26:39Z
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Methods for identifying adverse drug reactions in primary care: A systematic review

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