Abstract
The use of automated systems within the medication use process has significantly reduce the occurrence of medication errors and the associated clinical and financial burden. However, automated systems lull into a false sense of security and increase the risk of medication errors that are often associated with socio-technical interactions, automation bias, workarounds and overrides. The objective of the systematic review is to determine the prevalence, types and severity of medication errors that are associated the use of automated systems in ambulatory and institutionalized care settings. The search strategy will be guided by PRISMA framework. Selected databases and relevant gray literature were searched and screening was done independently by two researchers between 01 April and 29 June 2021. These covered all relevant articles published from the inception of the use of automation in the medication use process (2000) until 2020. De-duplication and screening of all studies were done independently by two researchers with a clear inclusion / exclusion criteria. Data extraction and synthesis are currently on going (started on 06 July 2021) and being conducted independently but the validity and completeness of the processes will be confirmed by the third researcher. The Cochrane Risk of Bias tool and the Hoy et al's quality assessment checklist will be used for the assessment of methodological bias while the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system will be used for the quality of evidence assessment. Detailed qualitative synthesis of key findings will be done with thematic and descriptive analyses. If the number and types of included studies permit, fixed or random effect model meta-analysis will be conducted based on the degree of homogeneity in the sampling frame used in the included studies. Heterogeneity will be assessed with I2 statistics and I2 > 50% will be considered a high statistical heterogeneity. The systematic review may provide new perspective especially from developing settings about the prevalence, types and severity of medication errors associated with the use of automated systems at all the stages of medication use process, and in all categories of patients. This may add to global knowledge in the research area. Systematic review registration: The systematic review was registered and published by PROSPERO (CRD42020212900).
Highlights
Appropriate use of rationally prescribed medications is critical to the achievement of optimal outcomes, but this is predicated on an error-free medication use process that ensures that medications are used effectively and safely, and their movement from one stage to the other fully tracked and documented [1]
The medication use process is in reality complex and involves multiple stages and professionals with different background, and this is associated with an increased risk of medication errors and adverse drug events (ADEs) [2,3]
The protocol for the systematic review will be focused on presenting a comprehensive review of published evidence about the frequency, types and severity of medication errors that encountered with the use of automated systems at all the stages of medication use process
Summary
Appropriate use of rationally prescribed medications is critical to the achievement of optimal outcomes, but this is predicated on an error-free medication use process that ensures that medications are used effectively and safely, and their movement from one stage to the other fully tracked and documented [1]. Automated systems are not error-proof as the observed improvement in medication use and patient safety associated with their use may lull healthcare professionals into a false sense of security from the occurrence of medication errors. This is because automated systems require a level of human interventions to function optimally, and the potential for errors exist. The objective of the systematic review is to determine the prevalence, types and severity of medication errors that are associated with the use of automated systems for adults and children in ambulatory and institutionalized care settings
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