From: Preventable medication harm across health care settings: a systematic review and meta-analysis
Outcome | Â | Preventable medication harm | Any medication harm | ||||
---|---|---|---|---|---|---|---|
Number of studies | Prevalence rate, % (95% CI) * | I2, % | Median (IQR) | Prevalence rate, % (95% CI) * | I2, % | Median (IQR) | |
Overall prevalence rate | 81 | 3 (2, 4) | 99 | 2.9 (0.02–27.1) | 9 (7, 11) | 99.5 | 9.8 (0.24–65.4) |
Healthcare system: | |||||||
 - General hospital or internal medicine | 29 | 2 (1, 2) | 98.4 | 1.6 (1.2–2.2) | 5 (4, 7) | 99.0 | 5.1 (3.2–10.9) |
 - Emergency department | 12 | 5 (2, 12) | 99.7 | 5.2 (2.1–12) | 9.3 (4, 21) | 99.8 | 6.2 (6.0–14) |
 - ICU | 6 | 7 (4, 12) | 91.1 | 6.8 (3.9–11.6) | 14 (8, 23) | 95.6 | 16.4 (9.5–20.2) |
 - Highly specialised care or surgical | 13 | 6 (3, 11) | 98.7 | 5.4 (3.0–9.7) | 18 (11, 26) | 99.3 | 22.9 (17.8–26.2) |
 - Paediatric | 9 | 1 (0, 2) | 94.9 | 1.1 (0.1–2.1) | 5 (2, 10) | 99.2 | 5 (2.4–14.3) |
 - Elderly | 7 | 11 (7, 15) | 95.9 | 10.7 (7.2–15.4) | 23 (13, 37) | 99.1 | 24.8 (16–31.3) |
 - Primary care | 4 | 1 (1, 2) | 84.9 | 1.2 (1–1.9) | 10 (6, 16) | 99.0 | 9.9 (8–13.9) |
 - Psychiatric | 1 | 1 (1, 2) | NA | NA | 10 (9, 12) | NA | NA |
Severity of preventable harm: | |||||||
 - Mild | NA | 39 (28, 51), n = 20 | 96.4 | 40 (21–49) | 50 (44, 56), n = 47 | 98 | 46.9 (35.9–63.1) |
 - Moderate | NA | 40 (31, 49), n = 22 | 93.6 | 36.5 (28.1–54.4) | 41 (36, 47), n = 54 | 98 | 37.3 (24.7–53.3) |
 - Severe/life-threatening | NA | 26 (15, 37), n = 28 | 97 | 19.5 (8–40) | 14 (10, 19), n = 55 | 98 | 10 (6.4–18.6) |
Stages of medication useβ: | |||||||
 1. Prescribing | 9 | 58 (42, 73), n = 9 | 94 | 55.8 (35.4–77.3) | 64 (34, 84), n = 18 | 98.5 | 52 (36–79) |
 2. Transcribing/documenting | 8 | 3 (0, 9), n = 8 | 78 | 0.9 (0–6.3) | 6 (1, 14), n = 17 | 89 | 2 (0.5–9) |
 3. Dispensing | 6 | 2 (0, 6), n = 6 | 47 | 3.8 (0.9–4.1) | 8 (2, 24), n = 15 | 69% | 5.6 (1.3–8) |
 4. Administering | 15 | 21 (11, 33), n = 15 | 93 | 20.8 (8.8–31.1) | 25 (12, 40), n = 32 | 96.8 | 19 (7.6–30) |
 5. Monitoring | 8 | 47 (21, 73), n = 8 | 99 | 54.9 (25.3–76) | 54 (16, 82), n = 15 | 100 | 35 (15–70) |