Systematic review of medication safety assessment methods

Meyer-Massetti, Carla; Cheng, Christine M.; Schwappach, David L. B.; Paulsen, Lynn; Ide, Brigid; Meier, Christoph R.; Guglielmo, B. Joseph
February 2011
American Journal of Health-System Pharmacy;2/1/2011, Vol. 68 Issue 3, p227
Academic Journal
Purpose. The accuracy, efficiency, and efficacy of four commonly recommended medication safety assessment methodologies were systematically reviewed. Methods. Medical literature databases were systematically searched for any comparative study conducted between January 2000 and October 2009 in which at least two of the four methodologies--incident report review, direct observation, chart review, and trigger tool--were compared with one another. Any study that compared two or more methodologies for quantitative accuracy (adequacy of the assessment of medication errors and adverse drug events) efficiency (effort and cost), and efficacy and that provided numerical data was included in the analysis. Results. Twenty-eight studies were included in this review. Of these, 22 compared two of the methodologies, and 6 compared three methods. Direct observation identified the greatest number of reports of drug-related problems (DRPs), while incident report review identified the fewest. However, incident report review generally showed a higher specificity compared to the other methods and most effectively captured severe DRPs. In contrast, the sensitivity of incident report review was lower when compared with trigger tool. While trigger tool was the least labor-intensive of the four methodologies, incident report review appeared to be the least expensive, but only when linked with concomitant automated reporting systems and targeted follow-up. Conclusion. All four medication safety assessment techniques--incident report review, chart review, direct observation, and trigger tool--have different strengths and weaknesses. Overlap between different methods in identifying DRPs is minimal. While trigger tool appeared to be the most effective and labor-efficient method, incident report review best identified high-severity DRPs.


Related Articles

  • PREVENTIVE STRATEGIES OF ADVERSE EVENTS WITH POTENTIALLY DANGEROUS MEDICATIONS. Giron Camerini, Flavia; Dopico da Silva, Lolita; Guimarães Gonçalves, Taylane; Mello de Lima, Fernanda; Lopes Thompson, Marina; Cruz Esteves Pessôa, Sabrina; Campos Santos, Caroline // Revista de Pesquisa: Cuidado e Fundamental;jul-set2013, Vol. 5 Issue 3, p142 

    Objective: To describe the strategies adopted by nurses for safe administration of a potentially dangerous drug in the intensive care unit. Method: This is an exploratory study literature which included articles about potentially dangerous drugs and medication errors in intensive care units...

  • Reflecting on intravenous drug administration: towards safer practice. Kirk, Sarah; Cookson, Jo // Infant;Sep2013, Vol. 9 Issue 5, p166 

    Neonatal drug administration errors continue to be an escalating problem within NICUs. A strategy to enhance learning and hopefully reduce the number of adverse incidents reported was needed. A literature review was found to be of limited benefit in identifying tools to enable clinical staff to...

  • A Review of Adverse Reactions in Infants From Medications in Breastmilk. Anderson, Philip O.; Manoguerra, Anthony S.; Valdés, Verónica // Clinical Pediatrics;Mar2016, Vol. 55 Issue 3, p236 

    The types and rate of adverse drug reactions experienced by breastfed infants whose mothers are taking medications has not been well defined. This article reviews the literature on adverse drug reactions in infants since a previous review in 2002. Case reports and studies of adverse drug...

  • The Safety of Yoga: A Systematic Review of Case Reports and Case Series on Adverse Events Associated with Yoga. Krucoff, Carol; Dobos, Gustav // Journal of Alternative & Complementary Medicine;May2014, Vol. 20 Issue 5, pA21 

    An abstract of the study "The Safety of Yoga: A Systematic Review of Case Reports and Case Series on Adverse Events Associated With Yoga" by Holger Cramer and colleagues is presented.

  • Can we forget the Mini-Mental State Examination? A systematic review of the validity of cognitive screening instruments within one month after stroke. Van Heugten, Caroline M.; Walton, L.; Hentschel, U. // Clinical Rehabilitation;Jul2015, Vol. 29 Issue 7, p694 

    Objective: To review systematically studies investigating the convergent, criterion, and predictive validity of multi-domain cognitive screening instruments in the first four weeks after stroke. Data sources: Electronic databases (Pubmed, PsycINFO, CINAHL, Embase) were searched until June 2014....

  • The value of clinical examination in diagnosing pelvic fractures in blunt trauma patients: a brief review. Den Boer, T. A. W.; Geurts, M.; Van Hulsteijn, L. T.; Mubarak, A.; Slingerland, J.; Zwart, B.; Heijden, G. J. M. G.; Blokhuis, T. J. // European Journal of Trauma & Emergency Surgery;Aug2011, Vol. 37 Issue 4, p373 

    Purpose of the study: To evaluate the value of a pelvic X-ray compared to clinical examination in diagnosing pelvic ring fractures, using computed tomography (CT) as the gold standard, in alert [Glasgow Coma Scale (GCS) ≥ 13] adult blunt trauma patients in the emergency room. Methods: A...

  • Immunoglobulin G4-related diseases in the head and neck: a systematic review. Mulholland, Graeme B.; Jeffery, Caroline C.; Satija, Paras; Côté, David W. J. // Journal of Otolaryngology -- Head & Neck Surgery;2015, Vol. 44 Issue 1, p1 

    Background: Immunoglobulin G4 related disease (IgG4-RD) is a poorly understood chronic inflammatory disorder affecting the middle-aged and elderly that can present to the otolaryngologist. We aim to summarize the current literature regarding the manifestations and management of IgG4-RD in the...

  • Optimal Dosages for Melatonin Supplementation Therapy in Older Adults: A Systematic Review of Current Literature. Vural, Esmée; Munster, Barbara; Rooij, Sophia // Drugs & Aging;Jun2014, Vol. 31 Issue 6, p441 

    Background: Melatonin is a hormone that regulates circadian rhythm, and its levels decline with age. As melatonin levels decrease, older adults are prone to develop disorders related to an altered circadian rhythm. The effective dose of melatonin supplementation in these disorders remains...

  • Systemic review on highly qualified screening tests for swallowing disorders following stroke: Validity and reliability issues. Poorjavad, Marziyeh; Jalaie, Shohreh // Journal of Research in Medical Sciences;Aug2014, Vol. 19 Issue 8, p776 

    The article focuses on the research conducted to analyse and screen Oropharyngeal swallowing disorders in acute alert stroke patients. It states that persistent Oropharyngeal dysphagia acts as a marker of poor prognosis in stroke patients and mentions that several risks are associated with...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics