Title
How Effective Are Electronic Medication Systems In Reducing Medication Error Rates And Associated Harm Among Hospital Inpatients? A Systematic Review And Meta-Analysis
Abstract
Objective: To conduct a systematic review and meta-analysis to assess: 1) changes in medication error rates and associated patient harm following electronic medication system (EMS) implementation; and 2) evidence of system-related medication errors facilitated by the use of an EMS.Materials and Methods: We searched Medline, Scopus, Embase, and CINAHL for studies published between January 2005 and March 2019, comparing medication errors rates with or without assessments of related harm (actual or potential) before and after EMS implementation. EMS was defined as a computer-based system enabling the prescribing, supply, and/or administration of medicines. Study quality was assessed.Results: There was substantial heterogeneity in outcomes of the 18 included studies. Only 2 were strong quality. Meta-analysis of 5 studies reporting change in actual harm post-EMS showed no reduced risk (RR: 1.22, 95% CI: 0.18-8.38, P= .8) and meta-analysis of 3 studies reporting change in administration errors found a significant reduction in error rates (RR: 0.77, 95% CI: 0.72-0.83, P= .004). Of 10 studies of prescribing error rates, 9 reported a reduction but variable denominators precluded meta-analysis. Twelve studies provided specific examples of system-related medication errors; 5 quantified their occurrence.Discussion and Conclusion: Despite the wide-scale adoption of EMS in hospitals around the world, the quality of evidence about their effectiveness in medication error and associated harm reduction is variable. Some confidence can be placed in the ability of systems to reduce prescribing error rates. However, much is still unknown about mechanisms which may be most effective in improving medication safety and design features which facilitate new error risks.
Year
DOI
Venue
2021
10.1093/jamia/ocaa230
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
Keywords
DocType
Volume
medication error, prescribing error, administration error, patient harm, health information technology
Journal
28
Issue
ISSN
Citations 
1
1067-5027
1
PageRank 
References 
Authors
0.37
0
5
Name
Order
Citations
PageRank
Peter J Gates110.37
Rae-Anne Hardie211.38
Magdalena Z Raban351.82
Ling Li4136.64
Johanna I. Westbrook527455.58