Objectives: Medication errors that occur in the acute care setting can lead to increased utilization of health care resources, especially when they cause temporary or permanent patient harm. A pragmatic literature review was conducted to assess the clinical and economic impact of medication errors in Canadian hospitals. Methods: A search of the MEDLINE database was conducted using the subject terms "medication error", "preventable adverse drug event" and "Canada". Studies were included if they described the frequency or cost of medication errors or preventable adverse drug events (pADEs) (defined as medication errors that cause patient harm), were conducted in a Canadian acute care setting, and were published in the last decade. Additional studies were selected from reference lists of identified studies. Studies were assessed for study design, setting, type of medications studied, and outcomes measured (event frequency, costs). Results: Eight studies were identified between 2004 and 2014. One study estimated the frequency of all pADEs at the national level using analysis of retrospective chart reviews (0.08% per admission). The remaining seven studies were conducted at individual institutions across Canada. Of these, three studies used chart review analysis to quantify the frequency of errors among all drug types (between 1.1% and 3.8% of all admissions), while four studies used chart review and direct observation to focus on quantifying the frequency of specific types of errors (dosing, labelling) for specific drug types (opioids, other IV medications). No studies assessed the cost of errors. Conclusions: Results of studies at both the national and regional level demonstrate that medication errors pose a significant clinical burden to patient care in Canadian acute care settings. Further research is needed to quantify the economic burden of these events to the health care system, in order to assist policy-makers and health administrators in prioritizing policies that support prevention efforts.
Baginska, E. (2015). The Clinical and Economic Burden of Medication Errors In The Canadian Acute Care Setting: A Review of Published Studies. Value in Health, 18(7), A545. https://doi.org/10.1016/j.jval.2015.09.1734