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Systematic review and meta-analysis of community pharmacy error rates in the USA: 1993–2015
  1. Patrick J Campbell1,
  2. Mira Patel1,
  3. Jennifer R Martin2,
  4. Ana L Hincapie3,
  5. David Rhys Axon1,
  6. Terri L Warholak1,
  7. Marion Slack1
  1. 1 Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, Arizona, USA
  2. 2 University of Arizona Health Sciences Library, University of Arizona, Tucson, Arizona, USA
  3. 3 Division of Pharmacy Practice and Administrative Sciences, James L Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio, USA
  1. Correspondence to Dr Patrick J Campbell; pcampbell{at}pharmacy.arizona.edu

Abstract

Importance While much is known about hospital pharmacy error rates in the USA, comparatively little is known about community pharmacy dispensing error rates.

Objective The aim of this study was to determine the rate of community pharmacy dispensing errors in the USA.

Methods English language, peer-reviewed observational and interventional studies that reported community pharmacy dispensing error rates in the USA from January 1993 to December 2015 were identified in 10 bibliographic databases and topic-relevant grey literature. Studies with a denominator reflecting the total number of prescriptions in the sample were necessary for inclusion in the meta-analysis. A random effects meta-analysis was conducted to estimate an aggregate community pharmacy dispensing error rate. Heterogeneity was assessed using the I2 statistic prior to analysis.

Results The search yielded a total of 8490 records, of which 11 articles were included in the systematic review. Two articles did not have adequate data components to be included in the meta-analysis. Dispensing error rates ranged from 0.00003% (43/1 420 091) to 55% (55/100). The meta-analysis included 1 461 128 prescriptions. The overall community pharmacy dispensing error rate was estimated to be 0.015 (95% CI 0.014 to 0.018); however, significant heterogeneity was observed across studies (I2=99.6). Stratification by study error identification methodology was found to have a significant impact on dispensing error rate (p<0.001).

Conclusion and relevance There are few published articles that describe community pharmacy dispensing error rates in the USA. Thus, there is limited information about the current rate of community pharmacy dispensing errors. A robust investigation is needed to assess dispensing error rates in the USA to assess the nature and magnitude of the problem and establish prevention strategies.

  • pharmacists
  • medication safety
  • human error
  • healthcare quality improvement

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors PJC assisted with search strategy, performed article screening, conducted meta-analysis, contributed to the writing of the manuscript, edited manuscript and submitted manuscript. MP, ALH, DRA and TLW assisted with search strategy, performed article screening and contributed to the writing of the manuscript. JRM assisted with the search strategy development, conducted literature search and maintained reference documentation. MS assisted with search strategy, conducted meta-analysis and contributed to the writing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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