Ambulatory Medication Safety in Primary Care: A Systematic Review

[摘要] Purpose: To review the literature on medication safety in primary care in the electronic health record era.Methods: Included studies measured rates and outcomes of medication safety in patients whose prescriptions were written in primary care clinics with electronic prescribing. Four investigators independently reviewed titles and analyzed abstracts with dual-reviewer review for eligibility, characteristics, and risk of bias.Results: 4 medications. The rate of PIPs varied widely (0.19% to 98.2%). The rate of ADEs was lower (0.47% to 14.7%). There was poor correlation of PIP and PPO with documented ADEs leading to physical harm.Conclusions: This literature is limited by its inconsistent and highly variable outcomes. The majority of medication safety studies in primary care were in high-risk populations and measured potential harms rather than actual harms. Applying algorithms to primary care medication lists significantly overestimates rate of actual harms.

[学科分类] 过敏症与临床免疫学

[关键词] Adverse Drug Events;Electronic Prescribing;Family Medicine;Medication Safety;Primary Health Care;Systematic Review