Incidence, nature and causes of medication errors in hospitalised patients in Middle Eastern countries: A systematic review

Abstract

Background and aim: Medication errors (MEs) are a major global issue, adversely impacting patient safety and health outcomes. Promoting patient safety through minimising MEs is therefore a key global healthcare objective. This study aims to systematically review the incidence, nature and causes of MEs in hospitalised patients in Middle Eastern countries. Method: A systematic search of studies related to MEs originated from Middle Eastern countries was performed using the following databases: MEDLINE, EMBASE, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Database of Systematic Reviews (CDSR), Centre for Review and Dissemination (CRD) database, Joanna Briggs Institute Library. A systematic review protocol was developed and registered with the Centre for Reviews and Dissemination (CRD). The title, abstract and full article were screened for inclusion. Each paper was assessed by two reviewers for methodological quality prior to inclusion in the review. Studies were critically appraised prior to data extraction and findings synthesised using a narrative approach. Results: Database searching identified 2611 studies; 51 met the inclusion criteria and originated from nine of fifteen Middle Eastern countries, largely Iran, Saudi Arabia and Israel. Preliminary review results indicate error incidence rates of between 11 and 90% of patients (depending on the method of data collection), with the categories of errors reported being mostly prescribing errors followed by administration, dispensing and transcribing. Deficiencies in staff knowledge, lack of experience, insufficient training, poor adherence with protocols and policies, miscommunication and excessive workload were identified as major causative factors. Conclusion: MEs occur at high rates of incidence in the Middle East. Causes of errors are multifactorial and should be targeted in future interventions, which are likely to be complex interventions at varying levels within the healthcare systems. This project is funded by QNRF (NPRP project NPRP–388-3-095).