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Prevalence, contributory factors and severity of medication errors associated with direct-acting oral anticoagulants in adult patients: a systematic review and meta-analysis.
- Source :
- European Journal of Clinical Pharmacology; Apr2022, Vol. 78 Issue 4, p623-645, 23p, 2 Diagrams, 1 Chart, 3 Graphs
- Publication Year :
- 2022
-
Abstract
- Purpose: This study aimed to estimate the prevalence, contributory factors, and severity of medication errors associated with direct acting oral anticoagulants (DOACs). Methods: A systematic review and meta-analysis were undertaken by searching 11 databases including Medline, Embase, and CINHAL between January 2008 and September 2020. The pooled prevalence of errors and predictive intervals were estimated using random-effects models using Stata software. Data related to error causation were synthesised according to Reason's accident causation model. Results: From the 5205 titles screened, 32 studies were included which were mostly based in hospitals and included DOAC treatment for thromboembolism and atrial fibrillation. The proportion of study population who experienced either prescription, administration, or dispensing error ranged from 5.3 to 37.3%. The pooled percentage of patients experiencing prescribing error was 20% (95% CI 15–25%; I<superscript>2</superscript> = 96%; 95% PrI 4–43%). Prescribing error constituted the majority of all error types with a pooled estimate of 78% (95%CI 73–82%; I<superscript>2</superscript> = 0) of all errors. The common reported causes were active failures including wrong drug, and dose for the indication. Mistakes such as non-consideration of renal function, and error-provoking conditions such as lack of knowledge were common contributing factors. Adverse events such as potentially fatal intracranial haemorrhage or patient deaths were linked to the errors but causality assessments were often missing. Conclusions: Despite their favourable safety profile, DOAC medication errors are common. There is a need to promote multidisciplinary working, guideline-adherence, training, and education of healthcare professionals, and the use of theory-based and technology-facilitated interventions to minimise errors and maximise the benefits of DOACs usage in all settings. Protocol: A protocol developed as per PRISMA-P guideline is registered under PROSPERO ID = CRD42019122996 [ABSTRACT FROM AUTHOR]
- Subjects :
- CINAHL database
META-analysis
MEDICAL information storage & retrieval systems
CONFIDENCE intervals
ORAL drug administration
SYSTEMATIC reviews
MEDICATION errors
ANTICOAGULANTS
ATRIAL fibrillation
DESCRIPTIVE statistics
THROMBOEMBOLISM
DRUG prescribing
DRUG side effects
MEDLINE
DATA analysis software
PHYSICIAN practice patterns
ADULTS
Subjects
Details
- Language :
- English
- ISSN :
- 00316970
- Volume :
- 78
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- European Journal of Clinical Pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 156400482
- Full Text :
- https://doi.org/10.1007/s00228-021-03212-y