Reducing medication errors for adults in hospital settings.

Area of Science:

• Health Services Research
• Patient Safety
• Clinical Pharmacy

Background:

• Medication errors are preventable events that can lead to patient harm, increased costs, and mortality in hospitalized adults.
• Identifying and implementing effective interventions is crucial for improving patient safety and healthcare outcomes.

Purpose of the Study:

• To systematically evaluate the effectiveness of interventions aimed at reducing medication errors in adult hospital settings.
• To synthesize evidence from randomized controlled trials (RCTs) and interrupted time series (ITS) studies.

Main Methods:

• Comprehensive literature search of multiple databases and trials registers up to January 2020.
• Inclusion of RCTs and ITS studies investigating interventions against usual care.
• Extraction and analysis of data on medication errors, adverse drug events (ADEs), and other patient outcomes.

Main Results:

• Medication reconciliation, computerised physician order entry (CPOE)/clinical decision support systems (CDSS), barcoding, feedback, and dispensing systems show potential to reduce medication errors and ADEs.
• Evidence for medication reconciliation and CPOE/CDSS is of moderate certainty, while other interventions have low-certainty evidence.
• Some interventions, like medication reconciliation by pharmacists, may reduce errors but potentially increase ADEs; results for length of stay and quality of life are often inconclusive.

Conclusions:

• Low- to moderate-certainty evidence suggests several interventions can reduce medication errors and ADEs in hospitals.
• Further high-quality, powered studies are needed to address evidence gaps and confirm intervention effectiveness.
• Exploring innovative, synergistic strategies, including patient involvement, is recommended for future research.