Professional, structural and organisational interventions in primary care for reducing medication errors

Khalil, Hanan; Bell, Brian; Chambers, Helen Phyllis; Sheikh, Aziz; Avery, Anthony J

doi:10.1002/14651858.cd003942.pub3

Cited by 64 publications

(77 citation statements)

References 111 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Alternately, most of the current reviews focused on the occurrence of medication errors, specific interventions to reduce medication errors and medication management [15][16][17][18][19][20][21][22]. While there are several reviews on medication programs focusing on the effect of medication errors and effectiveness of interventions, they do not describe the types of adverse events [21,22]. The review by Khalil et al, 2017 examined the effectiveness of various types of medication safety interventions to reduce mortality, emergency visits and hospital admissions.…”

Section: Introductionmentioning

confidence: 99%

“…While there are several reviews on medication programs focusing on the effect of medication errors and effectiveness of interventions, they do not describe the types of adverse events [21,22]. The review by Khalil et al, 2017 examined the effectiveness of various types of medication safety interventions to reduce mortality, emergency visits and hospital admissions. The authors found little evidence to support the benefits of organizational, professional and structural interventions addressing medication errors due to the heterogeneity of the included studies [21].…”

Section: Introductionmentioning

confidence: 99%

“…The review by Khalil et al, 2017 examined the effectiveness of various types of medication safety interventions to reduce mortality, emergency visits and hospital admissions. The authors found little evidence to support the benefits of organizational, professional and structural interventions addressing medication errors due to the heterogeneity of the included studies [21]. .Assiri et al, 2018 examined the prevalence of medications errors and adverse events associated with errors and risk factors associated with them.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Adverse drug reactions in primary care: a scoping review

Khalil

Huang

2020

BMC Health Serv Res

100

View full text Add to dashboard Cite

Background: Medication-related adverse events, or adverse drug reactions (ADRs) are harmful events caused by medication. ADRs could have profound effects on the patients' quality of life, as well as creating an increased burden on the healthcare system. ADRs are one of the rising causes of morbidity and mortality internationally, and will continue to be a significant public health issue with the increased complexity in medication, to treat various diseases in an aging society. This scoping review aims to provide a detailed map of the most common adverse drug reactions experienced in primary healthcare setting, the drug classes that are most commonly associated with different levels/types of adverse drug reactions, causes of ADRs, their prevalence and consequences of experiencing ADRs. Methods: We systematically reviewed electronic databases Ovid MEDLINE, Embase, CINAHL Plus, Cochrane Central Register of Controlled Trials, PsycINFO and Scopus. In addition, the National Patient Safety Foundation Bibliography and the Agency for Health Care Research and Quality and Patient Safety Net Bibliography were searched. Studies published from 1990 onwards until December 7, 2018 were included as the incidence of reporting drug reactions were not prevalent before 1990. We only include studies published in English. Results: The final search yielded a total of 19 citations for inclusion published over a 15-year period that primarily focused on investigating the different types of adverse drug reactions in primary healthcare. The most causes of adverse events were related to drug related and allergies. Idiosyncratic adverse reactions were not very commonly reported. The most common adverse drug reactions reported in the studies included in this review were those that are associated with the central nervous system, gastrointestinal system and cardiovascular system. Several classes of medications were reported to be associated with adverse events. Conclusion: This scoping review identified that the most causes of ADRs were drug related and due to allergies. Idiosyncratic adverse reactions were not very commonly reported in the literature. This is mainly because it is hard to predict and these reactions are not associated with drug doses or routes of administration. The most common ADRs reported in the studies included in this review were those that are associated with the central nervous system, gastrointestinal system and cardiovascular system. Several classes of medications were reported to be associated with ADRs.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adverse drug reactions in primary care: a scoping review

Khalil

Huang

2020

BMC Health Serv Res

100

View full text Add to dashboard Cite

show abstract

“…We considered the effect size for the primary outcome to be small to moderate, similar to the effects of various other interventions to improve professional practice [1][2][3][4][5][6][7][8][9].…”

Section: Discussion and Conclusion Limitationsmentioning

confidence: 99%

“…Another recent Cochrane review shows that healthcare professionals provided with clinical practice guidelines accompanied by tools developed by guideline producers probably improve their adherence to clinical guidelines [8]. Organisational interventions, such as provision of pharmaceutical care, medication reviews, follow-up visits by a healthcare, probably make little or no difference in medication errors by primary healthcare professionals in adult patients that lead to hospital admissions, emergency department visits, and death [9].…”

Section: Introductionmentioning

confidence: 99%

Patient-mediated interventions to improve professional practice: A summary of a Cochrane systematic review

Fønhus

Dalsbø

Johansen

et al. 2019

Patient Education and Counseling

View full text Add to dashboard Cite

To assess the effectiveness of patient-mediated interventions on healthcare professionals' performance. Methods We conducted a systematic Cochrane review according to established guidelines. We searched predefined databases in 2016 and 2017. Two review authors independently assessing studies for inclusion, extracted data, assessed risk of bias, performed meta-analyses, and used GRADE to assess the certainty of the evidence. Results We included 26 studies with a total of 12 552 patients. We found that patient-reported health information interventions probably improve healthcare professionals' adherence to recommended clinical practice (moderate certainty evidence). We also found that patient information interventions and patient education interventions may improve healthcare professionals' adherence to recommended clinical practice (low certainty evidence). Conclusion Our findings strengthen the belief that patient-mediated interventions have the potential to improve professional practice, especially patient-reported health information interventions. The impact of these interventions on patient health and satisfaction, adverse events and resource use, is more uncertain. Practice implications Our findings show that patient-mediated interventions are relevant approaches to improve professional practice. It seems fair to imply that patient-mediated interventions, and especially those where the patient herself provides information about own health, concerns or needs, demonstrate the importance of reciprocity when communicating with, and involving patients. We defined patient-mediated interventions according to Légaré 2014: "any intervention aimed at changing the performance of healthcare professionals through interactions with patients, or information provided by or to patients" [10]. Methods Our protocol was published in December 2016 [11]. More information on methods, such as detailed inclusion criteria can be found in the Cochrane review (ref).

show abstract

Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction

et al. 2018

View full text Add to dashboard Cite

IMPORTANCE Physician burnout has taken the form of an epidemic that may affect core domains of health care delivery, including patient safety, quality of care, and patient satisfaction. However, this evidence has not been systematically quantified.OBJECTIVE To examine whether physician burnout is associated with an increased risk of patient safety incidents, suboptimal care outcomes due to low professionalism, and lower patient satisfaction.DATA SOURCES MEDLINE, Embase, PsycInfo, and CINAHL databases were searched until October 22, 2017, using combinations of the key terms physicians, burnout, and patient care. Detailed standardized searches with no language restriction were undertaken. The reference lists of eligible studies and other relevant systematic reviews were hand-searched.STUDY SELECTION Quantitative observational studies.DATA EXTRACTION AND SYNTHESIS Two independent reviewers were involved. The main meta-analysis was followed by subgroup and sensitivity analyses. All analyses were performed using random-effects models. Formal tests for heterogeneity (I 2 ) and publication bias were performed. MAIN OUTCOMES AND MEASURESThe core outcomes were the quantitative associations between burnout and patient safety, professionalism, and patient satisfaction reported as odds ratios (ORs) with their 95% CIs. RESULTSOf the 5234 records identified, 47 studies on 42 473 physicians (25 059 [59.0%] men; median age, 38 years [range, 27-53 years]) were included in the meta-analysis. Physician burnout was associated with an increased risk of patient safety incidents (OR, 1.96; 95% CI, 1.59-2.40), poorer quality of care due to low professionalism (OR, 2.31; 95% CI, 1.87-2.85), and reduced patient satisfaction (OR, 2.28; 95% CI, 1.42-3.68). The heterogeneity was high and the study quality was low to moderate. The links between burnout and low professionalism were larger in residents and early-career (Յ5 years post residency) physicians compared with middle-and late-career physicians (Cohen Q = 7.27; P = .003). The reporting method of patient safety incidents and professionalism (physician-reported vs system-recorded) significantly influenced the main results (Cohen Q = 8.14; P = .007). CONCLUSIONS AND RELEVANCEThis meta-analysis provides evidence that physician burnout may jeopardize patient care; reversal of this risk has to be viewed as a fundamental health care policy goal across the globe. Health care organizations are encouraged to invest in efforts to improve physician wellness, particularly for early-career physicians. The methods of recording patient care quality and safety outcomes require improvements to concisely capture the outcome of burnout on the performance of health care organizations.

show abstract

Professional, structural and organisational interventions in primary care for reducing medication errors

Cited by 64 publications

References 111 publications

Adverse drug reactions in primary care: a scoping review

Adverse drug reactions in primary care: a scoping review

Patient-mediated interventions to improve professional practice: A summary of a Cochrane systematic review

Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction

Contact Info

Product

Resources

About