Medication Safety Incidents Associated with the Remote Delivery of Primary Care: A Rapid Review

Abstract

AbstractBackgroundThe COVID-19 pandemic triggered rapid, fundamental changes in how healthcare is delivered in communities, notably increased remote delivery of primary care. While the impact of these changes on medication safety are not yet fully understood, research conducted before the pandemic may provide evidence for possible consequences. This rapid review examines the published literature on medication safety incidents associated with the remote delivery of primary care.Objective(s)To examine the published literature on medication safety incidents associated with the remote delivery of primary care, with a focus on telemedicine and electronic prescribing.MethodsA rapid review was conducted according to the Cochrane Rapid Reviews Methods Group guidance. An electronic search was carried out on Embase and Medline (via PubMed) using key search terms “medication error”, “electronic prescribing”, “telemedicine” and “primary care”. Identified studies were synthesised narratively; reported medication safety incidents were categorised according to the WHO Conceptual Framework for the International Classification for Patient Safety.ResultsFifteen studies were deemed eligible for inclusion in this review. All fifteen studies reported medication incidents associated with electronic prescribing; no studies were identified that reported medication safety incidents associated with telemedicine. The most commonly reported medication safety incidents were ‘wrong label/instruction’ and ‘wrong dose/strength/frequency’. The frequency of medication safety incidents ranged from 0.89 to 81.98 incidents per 100 electronic prescriptions analysed.ConclusionsTo our knowledge, this is the first review to examine the literature on medication safety incidents associated with the remote delivery of primary care. Common incident types associated with electronic prescriptions were identified. There was wide variation in reported frequencies of medication safety incidents associated with electronic prescriptions. A gap in the literature was identified regarding medication safety incidents associated with telemedicine. Further research is required to determine the impact of the COVID-19 pandemic on medication safety in primary care.