Background Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all available evidences from literature to perform a focused examination of the prevalence and factors associated with medicine storage and wastage among urban households. This systematic review and meta-analysis mapped the existing literature on the burden, outcomes, and affective socio-economic factors of medicine storage among urban households. In addition, this study estimated pooled effect sizes for storage and wastage rates. Methods Household surveys evaluating modality, size, costs, and affective factors of medicines storage at home were searched in PubMed, EMBASE, OVID, SCOPUS, ProQuest, and Google scholar databases in 2019. Random effect meta-analysis and subgroup analysis were used to pool effect sizes for medicine storage and wastage prevalence among different geographical regions. Results From the 2604 initial records, 20 studies were selected for systematic review and 16 articles were selected for meta-analysis. An overall pooled-prevalence of medicine storage and real wastage rate was 77 and 15%, respectively. In this regard, some significant differences were observed between geographical regions. Southwest Asia region had the highest storage and wastage rates. The most common classes of medicines found in households belonged to the Infective agents for systemic (17.4%) and the Nervous system (16.4%). Moreover, income, education, age, the presence of chronic illness, female gender, and insurance coverage were found to be associated with higher home storage. The most commonly used method of disposal was throwing them in the garbage. Conclusions Factors beyond medical needs were also found to be associated with medicine storage, which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is establishing an adequate legislation and strict enforcement of regulations on dispensing, prescription, and marketing of medicines. Patient’s pressure on excessive prescription, irrational storage, and use of medicines deserve efficient community-centered programs, in order to increase awareness on these issues. So, hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.
Background: Irrational household storage of medicines is a world-wide problem resulting medicine wastage and associated harms, which imposes an additional burden on the health care system. The study has performed a systematic review of household surveys to provide strong evidences and policy implications through a comprehensive and comparative understanding of available global literatures. The review also maps existing literature on the burden, outcomes and affecting socio-economic factors of medicine storage and wastage.Methods: Five electronic databases were searched (from inception to 2019) for surveys that reviewed in-home medicine storage modality, size, cost and main determinants. The methodological quality of included studies was appraised through an adapted checklist developed by past studies.Results: From the initial 2604 records we identified, 22 studies met our inclusion criteria. In 16 studies, medicine storage rates were reported for more than 70%. The maximum rate of potential (not in use medicines) and real (expired or without expiration date medicine) wastage were about 70 and 40 percent, respectively. The most common classes of medicines found in households belonged to the nervous system (18%) and anti-infective for systemic use (15%). Income, education, age, presence of chronic illness, female gender and insurance coverage were among the factors influencing medicine storage. The most commonly used method of disposal was throwing them in the garbage.Conclusions: Factors beyond medical needs determined medicine storage in the studied contexts which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is adequate legislation and strict enforcement of regulations on dispensing, prescription and marketing of medicines. Patient pressure on excessive prescription, irrational storage and use of medicines deserve efficient community centered programs for increasing awareness of these issues. Hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.
Background: Medical errors have dramatic clinical and economic consequences. Using various information technology can reduce medical errors and improve services’ quality via preventing medical errors. In this study, the role of a computerized medical order entry system was investigated in reducing medical errors. Methods: This study was conducted as a scoping review. The research question was formulated; then, the inclusion and exclusion criteria, keywords (such as medical errors, adverse event, physician order entry system and control) and search strategy were determined. International databases(Scopus, ProQuest, and PubMed) and manual searches were used. The studies that had the inclusion criteria were entered into the study and were evaluated qualitatively, then information of studies was extracted and summarized. Results: In total, 16 studies were included. Most studies were about medication errors and adverse medication events. So, it is possible to claim more confidently about reducing medication errors to adverse medication events, since in studies, the impact of this system on medication errors had been further discussed. Some studies have pointed to an increase in error reports due to better checking and error entry with this system, and in general, the positive impact of this action has been mentioned in minimizing errors, especially medication errors and adverse medication events. Positive and significant effects have also been reported on prescribing errors, especially medication prescriptions. Conclusion: Computerization of medical orders through its positive effects, can be considered a useful and appropriate intervention in increasing patient safety if implemented completely and correctly.
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