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Quantitative exploration of medication errors among older people: a systematic review

Salmasi, S, Wimmer, BC ORCID: 0000-0003-3166-7126, Khan, TM, Patel, RP ORCID: 0000-0001-9344-1013 and Ming, LC ORCID: 0000-0002-6971-1383 2017 , 'Quantitative exploration of medication errors among older people: a systematic review' , Drugs and Therapy Perspectives , pp. 1-9 , doi: 10.1007/s40267-017-0468-9.

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Background: Medication errors (MEs) in older people areof importance due to global aging patterns. Following onfrom aging-related changes in pharmacokinetics, pharmacodynamics,and the potential presence of multiple comorbiditiestreated with polypharmacy, older people arehighly vulnerable to the effects and consequences of MEs.Objective: The primary outcome of this study was to systematicallyreview studies on the incidence and categoriesof MEs in older people. Secondary outcomes includedeconomic and clinical consequences of MEs in older people,risk factors for MEs in older people, and medicationsinvolved.Methods: A comprehensive, electronic search was conductedusing PubMed, EBSCOhost, OvidMedline andProquest central databases for studies evaluating MEs inolder people published in peer-reviewed journals beforeNovember 2017. A secondary manual search was alsoconducted by checking the bibliographies of includedstudies to identify other relevant studies. There was nolimitation imposed on the language, time of publication, orthe setting in which the study was carried out. The qualityof identified studies was assessed based on 17 criteriaadopted from Alsulami et al. and Metsa¨la¨ et al. The resultswere categorized using the phases of medication use whenthe error was detected or occurred.Results: Eighteen studies met the inclusion criteria with atotal of 467,193 participants from 11 countries. IdentifiedMEs were administration errors [number of times MEsubcategory was reported (n = 7); error frequency rate1.2–59.0%], prescribing errors (n = 7; 1.6–49.7%), transcribingerrors (n = 5; 15.0–70.2%), reconciliation errors(n = 4; 5.0–53.6%), and dispensing errors (n = 2;2.0–14.0%). People with polypharmacy had the highesttendency of MEs. Three studies reported severe clinicalconsequences from MEs ranging from 2.9% to 13.0%. Themain category of medications involved in MEs were cardiovascularmedications (n = 15); nervous system medications(n = 11); and medications for the alimentary tractand metabolism (n = 8).Conclusions: Administration and prescribing errors werethe most frequently reported MEs in older people. Medicationclasses that were most commonly reported in the context of MEs in older people were cardiovascular medicationsand nervous system medications. We identifiedpolypharmacy as a risk factor for MEs, which was found tocorrelate with the number of MEs in many stages ofmedication use. A lack of studies from Asia, Latin America,and Africa highlights the need for future research inthese regions.

Item Type: Article
Authors/Creators:Salmasi, S and Wimmer, BC and Khan, TM and Patel, RP and Ming, LC
Journal or Publication Title: Drugs and Therapy Perspectives
Publisher: Adis International Ltd
ISSN: 1172-0360
DOI / ID Number: 10.1007/s40267-017-0468-9
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Copyright 2017 Springer International Publishing AG, part of Springer Nature

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