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Purpose <p>To systematically review and synthesise evidence on the incidence, characteristics, risk factors, and clinical outcomes of repeat adverse drug reactions (ADRs) in older adults.</p> Methods <p>A comprehensive search of four major databases was conducted. Studies reporting data on both index (initial) and repeat ADRs in populations with a mean or median age ≥ 60&#xa0;years were included. A repeat ADR was defined as the occurrence of the same or a different ADR following an index ADR in the same individual. A meta-analysis estimated the pooled incidence rate (IR) of at least one repeat ADR-related hospitalisation. The protocol was registered in PROSPERO (CRD420251086319).</p> Results <p>Nine studies following participants with an index ADR to capture repeat ADRs and/or related hospitalisations were included. Seven examined repeat ADR-related hospitalisations, reporting incidences from 8.7 to 23.1% over 1–5&#xa0;years. In six of the seven studies (n = 30,284) with pre-specified follow-up, the IR of at least one repeat ADR-related hospitalisation ranged from 4.0 to 13.0 per 100 person-year, with a pooled IR of 7.0 per 100 person-year (95% CI 5.0–10.0; I<sup>2</sup> = 82.7%). Three studies found that the same drugs or drug classes were implicated in both index and repeat ADR-related hospitalisations in 41.7 to 60% of cases. In-hospital mortality among patients with repeat ADR-related hospitalisations ranged from 0 to 68.1% (3 studies).</p> Conclusion <p>Repeat ADRs and related hospitalisations pose a non-trivial risk in older adults and often involve the same drugs. Future research should evaluate system-level strategies to reduce preventable repeat events.</p>

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Epidemiology and characteristics of repeat adverse drug reactions and associated clinical outcomes in older adults: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月9日

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  • Behailu Terefe Tesfaye,
  • Gregory M. Peterson,
  • Woldesellassie M. Bezabhe,
  • Olive M. Schmid,
  • Mohammed S. Salahudeen

摘要

Purpose

To systematically review and synthesise evidence on the incidence, characteristics, risk factors, and clinical outcomes of repeat adverse drug reactions (ADRs) in older adults.

Methods

A comprehensive search of four major databases was conducted. Studies reporting data on both index (initial) and repeat ADRs in populations with a mean or median age ≥ 60 years were included. A repeat ADR was defined as the occurrence of the same or a different ADR following an index ADR in the same individual. A meta-analysis estimated the pooled incidence rate (IR) of at least one repeat ADR-related hospitalisation. The protocol was registered in PROSPERO (CRD420251086319).

Results

Nine studies following participants with an index ADR to capture repeat ADRs and/or related hospitalisations were included. Seven examined repeat ADR-related hospitalisations, reporting incidences from 8.7 to 23.1% over 1–5 years. In six of the seven studies (n = 30,284) with pre-specified follow-up, the IR of at least one repeat ADR-related hospitalisation ranged from 4.0 to 13.0 per 100 person-year, with a pooled IR of 7.0 per 100 person-year (95% CI 5.0–10.0; I2 = 82.7%). Three studies found that the same drugs or drug classes were implicated in both index and repeat ADR-related hospitalisations in 41.7 to 60% of cases. In-hospital mortality among patients with repeat ADR-related hospitalisations ranged from 0 to 68.1% (3 studies).

Conclusion

Repeat ADRs and related hospitalisations pose a non-trivial risk in older adults and often involve the same drugs. Future research should evaluate system-level strategies to reduce preventable repeat events.