Safety issues related to the use of prescription drugs in patients with chronic diseases: a bibliographic review

Purpose A literature review was conducted with the aim of investigating the impact of treatments associated with an increased risk of hypertension, hyperglycaemia, hyperkalaemia, bone fracture and serotonin syndrome, by taking into account the most prevalent pathologies, the drugs most frequently prescribed at the outpatient level, as well as the adverse effects they produce. Methods A bibliographical search of scientific publications in MEDLINE, published between 1 January 2006 and 31 December 2015 in English and Spanish, was conducted using 21 keywords. Data, primarily from editorials, non-US government supported research, and reviews, were collected. Other data sources included the websites for the Spanish Agency of Medicines and Medical Devices and the European Medicines Agency, information bulletins on therapeutic information (e.g. the International Society of Drug Bulletins ), other guidelines and reference books. Results From the 24,083 publications identified, 33 articles were selected and their full texts retrieved; 41 articles were included from the references from these articles. Other sources of data were 16 documents from regulatory agencies, seven bulletins, nine guidelines and two books. Approximately 25 therapeutic groups, including nonsteroidal anti-inflammatory drugs, β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, opioid analgesics, certain antidiabetics, antipsychotics, benzodiazepines and long-term oral corticosteroids, were found to be the most frequently involved in medication-related problems. Conclusions This review has helped identify a set of drugs that should be included in a strategy for ‘high-alert medications’ and in ambulatory care medication revisions for preventing adverse drug reactions, especially the therapeutic groups included in the high-risk drugs list for chronic or geriatric patients and those drugs responsible for emergency visits and hospital admissions.