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Mekonnen AB, Alhawassi TM, McLachlan AJ, et al. Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review. Drugs Real World Outcomes. 2018;5(1):1-24doi: 10.1007/s40801-017-0125-6.
Mekonnen, A. B., Alhawassi, T. M., McLachlan, A. J., & Brien, J. E. (2018). Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review. Drugs - real world outcomes, 5(1), 1-24. https://doi.org/10.1007/s40801-017-0125-6
Mekonnen, Alemayehu B, et al. "Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review." Drugs - real world outcomes vol. 5,1 (2018): 1-24. doi: https://doi.org/10.1007/s40801-017-0125-6
Mekonnen AB, Alhawassi TM, McLachlan AJ, Brien JE. Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review. Drugs Real World Outcomes. 2018 Mar;5(1):1-24. doi: 10.1007/s40801-017-0125-6. PMID: 29138993; PMCID: PMC5825388.
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Drugs Real World Outcomes. 2018 Mar;5(1):1-24. doi: 10.1007/s40801-017-0125-6.

Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review.

Drugs - real world outcomes

Alemayehu B Mekonnen, Tariq M Alhawassi, Andrew J McLachlan, Jo-Anne E Brien

Affiliations

  1. Faculty of Pharmacy, University of Sydney, S114, Pharmacy Building A15, Sydney, NSW, 2006, Australia. [email protected].
  2. School of Pharmacy, University of Gondar, Gondar, Ethiopia. [email protected].
  3. College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
  4. Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia.
  5. Faculty of Pharmacy, University of Sydney, S114, Pharmacy Building A15, Sydney, NSW, 2006, Australia.
  6. Centre for Education and Research on Ageing, Concord Hospital, Sydney, NSW, Australia.
  7. Faculty of Medicine, St Vincent's Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia.

PMID: 29138993 PMCID: PMC5825388 DOI: 10.1007/s40801-017-0125-6

Abstract

BACKGROUND: Medication errors and adverse drug events are universal problems contributing to patient harm but the magnitude of these problems in Africa remains unclear.

OBJECTIVE: The objective of this study was to systematically investigate the literature on the extent of medication errors and adverse drug events, and the factors contributing to medication errors in African hospitals.

METHODS: We searched PubMed, MEDLINE, EMBASE, Web of Science and Global Health databases from inception to 31 August, 2017 and hand searched the reference lists of included studies. Original research studies of any design published in English that investigated adverse drug events and/or medication errors in any patient population in the hospital setting in Africa were included. Descriptive statistics including median and interquartile range were presented.

RESULTS: Fifty-one studies were included; of these, 33 focused on medication errors, 15 on adverse drug events, and three studies focused on medication errors and adverse drug events. These studies were conducted in nine (of the 54) African countries. In any patient population, the median (interquartile range) percentage of patients reported to have experienced any suspected adverse drug event at hospital admission was 8.4% (4.5-20.1%), while adverse drug events causing admission were reported in 2.8% (0.7-6.4%) of patients but it was reported that a median of 43.5% (20.0-47.0%) of the adverse drug events were deemed preventable. Similarly, the median mortality rate attributed to adverse drug events was reported to be 0.1% (interquartile range 0.0-0.3%). The most commonly reported types of medication errors were prescribing errors, occurring in a median of 57.4% (interquartile range 22.8-72.8%) of all prescriptions and a median of 15.5% (interquartile range 7.5-50.6%) of the prescriptions evaluated had dosing problems. Major contributing factors for medication errors reported in these studies were individual practitioner factors (e.g. fatigue and inadequate knowledge/training) and environmental factors, such as workplace distraction and high workload.

CONCLUSION: Medication errors in the African healthcare setting are relatively common, and the impact of adverse drug events is substantial but many are preventable. This review supports the design and implementation of preventative strategies targeting the most likely contributing factors.

References

  1. Ann Pharmacother. 2008 Jul;42(7):1017-25 - PubMed
  2. Niger J Clin Pract. 2014 Mar-Apr;17(2):226-31 - PubMed
  3. PLoS One. 2009;4(2):e4439 - PubMed
  4. BMJ Open. 2016 Feb 23;6(2):e010003 - PubMed
  5. Stud Health Technol Inform. 2010;160(Pt 1):371-5 - PubMed
  6. Drug Saf. 2009;32(10):819-36 - PubMed
  7. J R Coll Gen Pract. 1989 Mar;39(320):110-2 - PubMed
  8. Med J Aust. 1995 Nov 6;163(9):458-71 - PubMed
  9. Pharmacoepidemiol Drug Saf. 2004 Mar;13(3):159-65 - PubMed
  10. Pharm Pract (Granada). 2013 Jan;11(1):51-7 - PubMed
  11. J Clin Pharmacol. 2003 Jul;43(7):768-83 - PubMed
  12. J Am Med Inform Assoc. 2013 May 1;20(3):470-6 - PubMed
  13. J Patient Saf. 2009 Mar;5(1):16-22 - PubMed
  14. Br J Clin Pharmacol. 2015 Oct;80(4):818-26 - PubMed
  15. Br J Clin Pharmacol. 1996 Sep;42(3):319-24 - PubMed
  16. PLoS One. 2015 Sep 04;10(9):e0136545 - PubMed
  17. PLoS One. 2014 Jan 28;9(1):e87338 - PubMed
  18. S Afr Med J. 2006 Jul;96(7):630-2 - PubMed
  19. Daru. 2013 Jun 20;21(1):49 - PubMed
  20. Drug Saf. 2009;32(5):379-89 - PubMed
  21. Int J Risk Saf Med. 2013;25(2):67-78 - PubMed
  22. Drug Saf. 2012 Feb 1;35(2):105-26 - PubMed
  23. PLoS One. 2012;7(3):e24061 - PubMed
  24. S Afr Med J. 2011 May;101(5):324-7 - PubMed
  25. J Patient Saf. 2016 Dec;12 (4):223-228 - PubMed
  26. Hosp Pharm. 1992 Jun;27(6):538 - PubMed
  27. Ann Afr Med. 2016 Jan-Mar;15(1):1-6 - PubMed
  28. J Clin Nurs. 2017 Nov;26(21-22):3610-3623 - PubMed
  29. Eur J Clin Pharmacol. 2013 Apr;69(4):995-1008 - PubMed
  30. Curr Drug Saf. 2015;10(2):136-44 - PubMed
  31. N Engl J Med. 1991 Feb 7;324(6):377-84 - PubMed
  32. BMC Nurs. 2015 Oct 21;14:53 - PubMed
  33. CMAJ. 2004 May 25;170(11):1688-9 - PubMed
  34. S Afr Med J. 2006 Dec;96(12):1255-9 - PubMed
  35. Drug Saf. 2005;28(10):891-900 - PubMed
  36. Drug Saf. 2013 Dec;36(12):1151-7 - PubMed
  37. Int J Risk Saf Med. 2011;23(1):11-6 - PubMed
  38. PLoS One. 2012;7(3):e33236 - PubMed
  39. Acta Paediatr. 2011 Oct;100(10):e169-74 - PubMed
  40. BMC Pediatr. 2015 Jul 15;15:83 - PubMed
  41. Am J Health Syst Pharm. 2007 Jul 1;64(13):1422-6 - PubMed
  42. Int Arch Med. 2012 May 04;5(1):15 - PubMed
  43. Eur J Clin Pharmacol. 2002 Oct;58(7):479-82 - PubMed
  44. World Health Organ Tech Rep Ser. 1969;425:5-24 - PubMed
  45. Am J Med Qual. 2009 Nov-Dec;24(6):525-8 - PubMed
  46. Ther Adv Drug Saf. 2012 Feb;3(1):25-34 - PubMed
  47. J Basic Clin Pharm. 2013 Dec;5(1):7-14 - PubMed
  48. East Mediterr Health J. 2009 Sep-Oct;15(5):1145-55 - PubMed
  49. Ann Afr Med. 2013 Oct-Dec;12(4):223-31 - PubMed
  50. Ann Pharmacother. 2013 Feb;47(2):237-56 - PubMed
  51. J Multidiscip Healthc. 2011;4:377-82 - PubMed
  52. Niger Med J. 1979 Mar;9(3):379-82 - PubMed
  53. Drug Saf. 2015 May;38(5):437-53 - PubMed
  54. Drug Saf. 2008;31(1):21-37 - PubMed
  55. J Nurs Manag. 2009 Sep;17(6):679-97 - PubMed
  56. BMC Res Notes. 2015 Sep 16;8:448 - PubMed
  57. Niger Postgrad Med J. 2004 Mar;11(1):37-9 - PubMed
  58. Drug Saf. 2000 Feb;22(2):161-8 - PubMed
  59. Anaesth Intensive Care. 2001 Oct;29(5):494-500 - PubMed
  60. Drug Saf. 2010 Mar 1;33(3):233-44 - PubMed
  61. PLoS One. 2013 Jun 20;8(6):e68856 - PubMed
  62. Nig Q J Hosp Med. 2007 Apr-Jun;17(2):74-8 - PubMed
  63. Drug Saf. 2013 Nov;36(11):1045-67 - PubMed
  64. J Gen Intern Med. 1995 Apr;10(4):199-205 - PubMed
  65. Afr J Med Med Sci. 2013 Dec;42(4):339-46 - PubMed
  66. Br J Clin Pharmacol. 2008 Mar;65(3):396-406 - PubMed
  67. Clin Pharmacol Ther. 1981 Aug;30(2):239-45 - PubMed
  68. J Patient Saf. 2016 Mar;12 (1):34-9 - PubMed
  69. Int J Qual Health Care. 2003 Dec;15 Suppl 1:i49-59 - PubMed
  70. Drug Saf. 2004;27(11):819-29 - PubMed
  71. Int J Risk Saf Med. 2016 Aug 22;28(2):77-91 - PubMed
  72. Fam Community Health. 1982 Aug;5(2):58-67 - PubMed
  73. Drug Saf. 1994 Feb;10(2):93-102 - PubMed
  74. Anaesthesia. 2005 Mar;60(3):257-73 - PubMed
  75. Afr Health Sci. 2011 Mar;11(1):72-8 - PubMed
  76. J Clin Pharm Ther. 2016 Apr;41(2):128-44 - PubMed
  77. S Afr Med J. 1985 May 11;67(19):770-2 - PubMed
  78. Int J Qual Health Care. 2010 Oct;22(5):380-5 - PubMed
  79. N Engl J Med. 1991 Feb 7;324(6):370-6 - PubMed
  80. Int Arch Med. 2014 May 03;7:18 - PubMed
  81. Clin Interv Aging. 2014 Dec 01;9:2079-86 - PubMed
  82. Int Arch Med. 2011 Oct 04;4:32 - PubMed
  83. J Am Med Inform Assoc. 2016 Mar;23 (2):366-74 - PubMed
  84. Ann Intern Med. 2004 May 18;140(10):795-801 - PubMed
  85. Sao Paulo Med J. 2011 May;129(3):153-64 - PubMed
  86. Therapie. 1985 Mar-Apr;40(2):111-8 - PubMed
  87. Eur J Pediatr. 2010 May;169(5):603-11 - PubMed
  88. Medicine (Baltimore). 2016 May;95(19):e3437 - PubMed
  89. J Matern Fetal Neonatal Med. 2012 Aug;25(8):1379-82 - PubMed
  90. BMJ Open. 2017 Jan 20;7(1):e010568 - PubMed
  91. Aust New Zealand Health Policy. 2009 Aug 11;6:18 - PubMed
  92. Anaesth Intensive Care. 2009 Jan;37(1):93-8 - PubMed
  93. BMC Pediatr. 2016 Jul 07;16:81 - PubMed
  94. J Obstet Gynaecol. 2005 Oct;25(7):676-80 - PubMed
  95. BMJ. 2016 May 03;353:i2139 - PubMed
  96. PLoS Med. 2009 Jul 21;6(7):e1000097 - PubMed
  97. JAMA. 1980 Dec 12;244(23):2617-20 - PubMed

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