Strategies to reduce medication errors with reference to older adults.

Area of Science:

• Gerontology
• Pharmacology
• Patient Safety

Background:

• Older adults (65+) have high prescription medication use (86%), with 83% over 85 using multiple medications.
• Medication errors contribute to 2-3% of Australian hospital admissions, with older individuals at higher risk.
• Common errors include prescribing, dispensing, administration, and recording issues in both hospital and community settings.

Purpose of the Study:

• To identify evidence-based strategies for preventing medication errors in older persons (65+) across acute, subacute, and residential care.
• Focus on errors related to prescribing, dispensing, and administration of medicines.

Main Methods:

• Comprehensive literature search of major databases (PubMed, Embase, Cochrane) from 1986 to present.
• Inclusion of systematic reviews, RCTs, and other study designs evaluating medication error management strategies.
• Data analysis included relative risks, odds ratios, and narrative summaries for diverse study types.

Main Results:

• Computerized physician order entry with decision support systems.
• Individual medication supply systems over ward stock.
• Involvement of clinical pharmacists in inpatient settings.
• Two-nurse verification of medication orders before dispensing.
• Establishment of a Medication Administration Review and Safety committee.
• Bedside glucose monitoring and nurse education for timely insulin administration.

Conclusions:

• Evidence for most intervention strategies to reduce medication errors in older adults is currently weak.
• High-quality controlled trials are essential across all medication prescription and delivery processes.
• Further research is needed to strengthen the evidence base for effective interventions.