title: Identifying high-risk medication: a systematic literature review.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Increasing focus on seven drugs/drug classes can potentially reduce hospitalizations, extended hospitalizations, disability, life-threatening conditions, and death by almost 50 %.
authors.affiliation: Department of Clinical Pharmacology, Aarhus University Hospital, Wilhelm Meyers Allé 4, 8000, Aarhus C, Denmark, ea@farm.au.dk.
authors.forename: Eva A
authors.initials: EA
authors.lastname: Saedder
authors.forename: Birgitte
authors.initials: B
authors.lastname: Brock
authors.forename: Lars Peter
authors.initials: LP
authors.lastname: Nielsen
authors.forename: Dorthe K
authors.initials: DK
authors.lastname: Bonnerup
authors.forename: Marianne
authors.initials: M
authors.lastname: Lisby
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008508:Medication Errors / Q000145:classification / Q000706:statistics & numerical data*; D004364:Pharmaceutical Preparations / Q000145:classification
chemical_list: D004364:Pharmaceutical Preparations