Get started
Work

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

Year: 2026
Type: review
Abstract: 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; I 2 = 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.
DOI: 10.1007/s41999-026-01501-2
Language: English
Field: Medicine
Open Access status: hybrid
Estimated APC paid: $2,390
OpenAlex ID: W7160697525
FWCI:
Cites: 41
Cited by:
Related to: