Here we discuss 15 recommendations for reducing the risks of medication errors:  1. Provision of sufficient undergraduate learning opportunities to make medical students safe prescribers.  2. Provision of opportunities for students to practise skills that help to reduce errors.  3. Education of students about common types of medication errors and how to avoid them.  4. Education of prescribers in taking accurate drug histories.  5. Assessment in medical schools of prescribing knowledge and skills and demonstration that newly qualified doctors are safe prescribers.  6. European harmonization of prescribing and safety recommendations and regulatory measures, with regular feedback about rational drug use.  7. Comprehensive assessment of elderly patients for declining function.  8. Exploration of low‐dose regimens for elderly patients and preparation of special formulations as required.  9. Training for all health‐care professionals in drug use, adverse effects, and medication errors in elderly people. 10. More involvement of pharmacists in clinical practice. 11. Introduction of integrated prescription forms and national implementation in individual countries. 12. Development of better monitoring systems for detecting medication errors, based on classification and analysis of spontaneous reports of previous reactions, and for investigating the possible role of medication errors when patients die. 13. Use of IT systems, when available, to provide methods of avoiding medication errors; standardization, proper evaluation, and certification of clinical information systems. 14. Nonjudgmental communication with patients about their concerns and elicitation of symptoms that they perceive to be adverse drug reactions. 15. Avoidance of defensive reactions if patients mention symptoms resulting from medication errors.

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BACKGROUND Electronic inhalation monitoring devices (EIMDs) are available to remind patients with respiratory diseases to take their medication and register inhalations for feedback to patients and health care providers as well as for data collection in research settings. OBJECTIVE This study aimed to assess the validity as well as the patient-reported usability and acceptability of an EIMD. METHODS This observational study planned to include 21 community pharmacies in the Netherlands. Patient-reported inhalations were collected and compared to EIMD registrations to evaluate the positive predictive value of these registrations as actual patient inhalations. Patients received questionnaires on their experiences and acceptance. RESULTS A convenience sample of 32 patients was included from across 18 pharmacies, and 932 medication doses were validated. Of these, 796 registrations matched with patient-reported use (true-positive, 85.4%), and 33 inhalation registrations did not match with patient-reported use (false-positive, 3.5%). The positive predictive value was 96.0%, and 103 patient-reported inhalations were not recorded in the database (false-negative, 11.1%). Overall, patients considered the EIMD to be acceptable and easy to use, but many hesitated to continue its use. Reminders and motivational messages were not appreciated by all users, and more user-tailored features in the app were desired. CONCLUSIONS Patients’ interaction with the device in real-world settings is critical for objective measurement of medication adherence. The positive predictive value of this EIMD was found to be acceptable. However, patients reported false-negative registrations and a desire to include more user-tailored features to increase the usability and acceptability of the EIMD.