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Exploring medication safety in prisons: a scoping review
Mohammed Alsuwat1, Jennifer Shaw2, Richard Neil Keers3,4,5
1Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, University of Manchester, The University of Manchester Faculty of Biology Medicine and Health, Manchester, England, UK alsuwatmohammed@gmail.com.
BMJ Open
|March 25, 2026
Summary
This review highlights medication safety challenges in prisons, finding non-adherence is common. Pharmacist-led interventions show promise, but more research is needed for drug-related problems (DRPs) beyond non-adherence.
Area of Science:
- Healthcare Management
- Public Health
- Pharmacovigilance
Background:
- Prison populations have complex health needs, increasing risks for drug-related problems (DRPs).
- Medication safety in correctional facilities is under-researched compared to hospital or primary care settings.
- Unique institutional constraints in prisons can impact safe medication use.
Purpose of the Study:
- To understand the nature and frequency of medication safety incidents in prison healthcare.
- To identify factors contributing to drug-related problems (DRPs) in incarcerated individuals.
- To evaluate strategies for improving medication safety within prison settings.
Main Methods:
- A systematic literature search was conducted across six databases (2000-2023).
- Included quantitative, qualitative, and mixed-methods studies on DRPs in prison healthcare.
- Data extraction and validation followed PRISMA-Scoping Review guidelines.
Main Results:
- 42 studies were included, primarily from the USA and UK, focusing on infectious diseases (especially HIV) and mental health.
- Medication non-adherence was the most frequent DRP, influenced by delivery issues, psychosocial factors, and security conflicts.
- Five intervention studies showed potential efficacy of multidisciplinary and pharmacist-led approaches, particularly for non-adherence.
Conclusions:
- This is the first comprehensive review of medication safety evidence in prison healthcare.
- While interventions show promise, further research is needed on DRPs beyond non-adherence.
- Future studies should focus on preventable medication errors and adverse drug events (ADEs) to develop targeted prison-specific interventions.
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