Medication Safety in the Community: A Review of the Literature

In 2002 the Second National Report on Patient Safety: Improving Medication Safety provided an estimate of the frequency, costs and potential preventability of adverse drug events (ADEs) and medication errors in Australia. Despite the majority of medication use occurring in the community, the report acknowledged that much of what was known about medication safety came from research conducted in the more structured hospital environment. This literature review was undertaken by the National Prescribing Service

• Limited (NPS) to obtain a greater understanding of medication safety issues in the community setting. The review explores 3 key areas:
• Outcomes and prevalence of ADEs and medication errors in the community.
• Factors contributing to or increasing the risk of ADEs and medication errors.

Interventions to reduce ADEs that result in mortality, hospital admissions, emergency department (ED) attendances and/or morbidity in the community. Researchers conducted searches of key bibliographic databases (Ovid MEDLINE(R) Medicine and In-Process & Other Non-Indexed Citations, EMBASE, CINAHL, Australian Medical Index and the Cochrane Database) for relevant articles between January 1995 and February 2008. Articles published in the Medical Journal of Australia, the British Medical Journal and Quality and Safety in Healthcare were reviewed along with reference lists of relevant articles. The search strategy identified 6238 articles relating to the 3 main search concepts ‘medication incidents’, ‘drug therapy’ and ‘community setting’. Two researchers reviewed titles, abstracts and later articles to identify relevant articles that met the eligibility criteria for each section of the study. The reviewers identified 170 articles meeting criteria for the outcomes and prevalence of ADEs, 62 articles about risk factors and contributing factors and 100 articles addressing criteria for medication safety interventions.

Link to report: Medication Safety in the Community: A Review of the Literature