Medications that reduce emergency hospital admissions: An overview of systematic reviews and prioritisation of treatments

Research output: Contribution to journalArticle

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Medications that reduce emergency hospital admissions : An overview of systematic reviews and prioritisation of treatments. / Bobrovitz, Niklas; Heneghan, Carl; Onakpoya, Igho; Fletcher, Benjamin; Collins, Dylan; Tompson, Alice; Lee, Joseph; Nunan, David; Fisher, Rebecca; Scott, Brittney; O'Sullivan, Jack; Van Hecke, Oliver; Nicholson, Brian D.; Stevens, Sarah; Roberts, Nia; Mahtani, Kamal R.

In: BMC Medicine, Vol. 16, 115, 26.07.2018, p. 1-14.

Research output: Contribution to journalArticle

Harvard

Bobrovitz, N, Heneghan, C, Onakpoya, I, Fletcher, B, Collins, D, Tompson, A, Lee, J, Nunan, D, Fisher, R, Scott, B, O'Sullivan, J, Van Hecke, O, Nicholson, BD, Stevens, S, Roberts, N & Mahtani, KR 2018, 'Medications that reduce emergency hospital admissions: An overview of systematic reviews and prioritisation of treatments', BMC Medicine, vol. 16, 115, pp. 1-14. https://doi.org/10.1186/s12916-018-1104-9

APA

Bobrovitz, N., Heneghan, C., Onakpoya, I., Fletcher, B., Collins, D., Tompson, A., Lee, J., Nunan, D., Fisher, R., Scott, B., O'Sullivan, J., Van Hecke, O., Nicholson, B. D., Stevens, S., Roberts, N., & Mahtani, K. R. (2018). Medications that reduce emergency hospital admissions: An overview of systematic reviews and prioritisation of treatments. BMC Medicine, 16, 1-14. [115]. https://doi.org/10.1186/s12916-018-1104-9

Vancouver

Author

Bobrovitz, Niklas ; Heneghan, Carl ; Onakpoya, Igho ; Fletcher, Benjamin ; Collins, Dylan ; Tompson, Alice ; Lee, Joseph ; Nunan, David ; Fisher, Rebecca ; Scott, Brittney ; O'Sullivan, Jack ; Van Hecke, Oliver ; Nicholson, Brian D. ; Stevens, Sarah ; Roberts, Nia ; Mahtani, Kamal R. / Medications that reduce emergency hospital admissions : An overview of systematic reviews and prioritisation of treatments. In: BMC Medicine. 2018 ; Vol. 16. pp. 1-14.

Bibtex

@article{c15e1426f57340c6921a1de9cbac78d5,
title = "Medications that reduce emergency hospital admissions: An overview of systematic reviews and prioritisation of treatments",
abstract = "BackgroundRates of emergency hospitalisations are increasing in many countries, leading to disruption in the quality of care and increases in cost. Therefore, identifying strategies to reduce emergency admission rates is a key priority. There have been large-scale evidence reviews to address this issue; however, there have been no reviews of medication therapies, which have the potential to reduce the use of emergency health-care services. The objectives of this study were to review systematically the evidence to identify medications that affect emergency hospital admissions and prioritise therapies for quality measurement and improvement. MethodsThis was a systematic review of systematic reviews. We searched MEDLINE, PubMed, the Cochrane Database of Systematic Reviews & Database of Abstracts of Reviews of Effects, Google Scholar and the websites of ten major funding agencies and health charities, using broad search criteria. We included systematic reviews of randomised controlled trials that examined the effect of any medication on emergency hospital admissions among adults. We assessed the quality of reviews using AMSTAR. To prioritise therapies, we assessed the quality of trial evidence underpinning meta-analysed effect estimates and cross-referenced the evidence with clinical guidelines. ResultsWe identified 140 systematic reviews, which included 1968 unique randomised controlled trials and 925,364 patients. Reviews contained 100 medications tested in 47 populations. We identified high-to moderate-quality evidence for 28 medications that reduced admissions. Of these medications, 11 were supported by clinical guidelines in the United States, the United Kingdom and Europe. These 11 therapies were for patients with heart failure (angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, aldosterone receptor antagonists and digoxin), stable coronary artery disease (intensive statin therapy), asthma exacerbations (early inhaled corticosteroids in the emergency department and anticholinergics), chronic obstructive pulmonary disease (long-acting muscarinic antagonists and long-acting beta-2 adrenoceptor agonists) and schizophrenia (second-generation antipsychotics and depot/maintenance antipsychotics). ConclusionsWe identified 11 medications supported by strong evidence and clinical guidelines that could be considered in quality monitoring and improvement strategies to help reduce emergency hospital admission rates. The findings are relevant to health systems with a large burden of chronic disease and those managing increasing pressures on acute health-care services.",
keywords = "clinical guidelines, drug, emergency admissions, hospital admissions, medication, overview, pharmacology, systematic review, unplanned admissions, unscheduled admissions",
author = "Niklas Bobrovitz and Carl Heneghan and Igho Onakpoya and Benjamin Fletcher and Dylan Collins and Alice Tompson and Joseph Lee and David Nunan and Rebecca Fisher and Brittney Scott and Jack O'Sullivan and {Van Hecke}, Oliver and Nicholson, {Brian D.} and Sarah Stevens and Nia Roberts and Mahtani, {Kamal R.}",
year = "2018",
month = jul,
day = "26",
doi = "10.1186/s12916-018-1104-9",
language = "English",
volume = "16",
pages = "1--14",
journal = "BMC Medicine",
issn = "1741-7015",

}

RIS

TY - JOUR

T1 - Medications that reduce emergency hospital admissions

T2 - An overview of systematic reviews and prioritisation of treatments

AU - Bobrovitz, Niklas

AU - Heneghan, Carl

AU - Onakpoya, Igho

AU - Fletcher, Benjamin

AU - Collins, Dylan

AU - Tompson, Alice

AU - Lee, Joseph

AU - Nunan, David

AU - Fisher, Rebecca

AU - Scott, Brittney

AU - O'Sullivan, Jack

AU - Van Hecke, Oliver

AU - Nicholson, Brian D.

AU - Stevens, Sarah

AU - Roberts, Nia

AU - Mahtani, Kamal R.

PY - 2018/7/26

Y1 - 2018/7/26

N2 - BackgroundRates of emergency hospitalisations are increasing in many countries, leading to disruption in the quality of care and increases in cost. Therefore, identifying strategies to reduce emergency admission rates is a key priority. There have been large-scale evidence reviews to address this issue; however, there have been no reviews of medication therapies, which have the potential to reduce the use of emergency health-care services. The objectives of this study were to review systematically the evidence to identify medications that affect emergency hospital admissions and prioritise therapies for quality measurement and improvement. MethodsThis was a systematic review of systematic reviews. We searched MEDLINE, PubMed, the Cochrane Database of Systematic Reviews & Database of Abstracts of Reviews of Effects, Google Scholar and the websites of ten major funding agencies and health charities, using broad search criteria. We included systematic reviews of randomised controlled trials that examined the effect of any medication on emergency hospital admissions among adults. We assessed the quality of reviews using AMSTAR. To prioritise therapies, we assessed the quality of trial evidence underpinning meta-analysed effect estimates and cross-referenced the evidence with clinical guidelines. ResultsWe identified 140 systematic reviews, which included 1968 unique randomised controlled trials and 925,364 patients. Reviews contained 100 medications tested in 47 populations. We identified high-to moderate-quality evidence for 28 medications that reduced admissions. Of these medications, 11 were supported by clinical guidelines in the United States, the United Kingdom and Europe. These 11 therapies were for patients with heart failure (angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, aldosterone receptor antagonists and digoxin), stable coronary artery disease (intensive statin therapy), asthma exacerbations (early inhaled corticosteroids in the emergency department and anticholinergics), chronic obstructive pulmonary disease (long-acting muscarinic antagonists and long-acting beta-2 adrenoceptor agonists) and schizophrenia (second-generation antipsychotics and depot/maintenance antipsychotics). ConclusionsWe identified 11 medications supported by strong evidence and clinical guidelines that could be considered in quality monitoring and improvement strategies to help reduce emergency hospital admission rates. The findings are relevant to health systems with a large burden of chronic disease and those managing increasing pressures on acute health-care services.

AB - BackgroundRates of emergency hospitalisations are increasing in many countries, leading to disruption in the quality of care and increases in cost. Therefore, identifying strategies to reduce emergency admission rates is a key priority. There have been large-scale evidence reviews to address this issue; however, there have been no reviews of medication therapies, which have the potential to reduce the use of emergency health-care services. The objectives of this study were to review systematically the evidence to identify medications that affect emergency hospital admissions and prioritise therapies for quality measurement and improvement. MethodsThis was a systematic review of systematic reviews. We searched MEDLINE, PubMed, the Cochrane Database of Systematic Reviews & Database of Abstracts of Reviews of Effects, Google Scholar and the websites of ten major funding agencies and health charities, using broad search criteria. We included systematic reviews of randomised controlled trials that examined the effect of any medication on emergency hospital admissions among adults. We assessed the quality of reviews using AMSTAR. To prioritise therapies, we assessed the quality of trial evidence underpinning meta-analysed effect estimates and cross-referenced the evidence with clinical guidelines. ResultsWe identified 140 systematic reviews, which included 1968 unique randomised controlled trials and 925,364 patients. Reviews contained 100 medications tested in 47 populations. We identified high-to moderate-quality evidence for 28 medications that reduced admissions. Of these medications, 11 were supported by clinical guidelines in the United States, the United Kingdom and Europe. These 11 therapies were for patients with heart failure (angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, aldosterone receptor antagonists and digoxin), stable coronary artery disease (intensive statin therapy), asthma exacerbations (early inhaled corticosteroids in the emergency department and anticholinergics), chronic obstructive pulmonary disease (long-acting muscarinic antagonists and long-acting beta-2 adrenoceptor agonists) and schizophrenia (second-generation antipsychotics and depot/maintenance antipsychotics). ConclusionsWe identified 11 medications supported by strong evidence and clinical guidelines that could be considered in quality monitoring and improvement strategies to help reduce emergency hospital admission rates. The findings are relevant to health systems with a large burden of chronic disease and those managing increasing pressures on acute health-care services.

KW - clinical guidelines

KW - drug

KW - emergency admissions

KW - hospital admissions

KW - medication

KW - overview

KW - pharmacology

KW - systematic review

KW - unplanned admissions

KW - unscheduled admissions

UR - http://www.scopus.com/inward/record.url?scp=85050494520&partnerID=8YFLogxK

U2 - 10.1186/s12916-018-1104-9

DO - 10.1186/s12916-018-1104-9

M3 - Article

C2 - 30045724

AN - SCOPUS:85050494520

VL - 16

SP - 1

EP - 14

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

M1 - 115

ER -