Despite over 2 decades of research into medication safety, preventable adverse drug events (ADEs) continue to be a problem of epidemic proportions in the outpatient setting. A recent systematic review estimates that 18 ADEs and almost 7 preventable ADEs occur per 100 outpatients annually.1 Reasons for the relative lack of progress include the ever-increasing use and types of medications at our disposal, an incomplete understanding of the causes and predictors of ADEs, and the lack of tools and techniques proven effective in improving medication safety, particularly in the outpatient setting. But by far the biggest problem is the lack of implementation of those tools already shown tobe effective. For example, in Massachusetts in 2007, only 35% of surveyed practices used an electronic health record, and between 2005 and 2007 there had been no significant increase in the availability or use of 9 of 10 key features of electronic health records, such as order entry and decision support, that are likely necessary for improved safety in the outpatient setting.2
Schnipper JL. Medication Safety: Are We There Yet? Comment on “Potentially Inappropriate Medications Defined by STOPP Criteria and the Risk of Adverse Drug Events in Older Hospitalized Patients”. Arch Intern Med. 2011;171(11):1019–1020. doi:10.1001/archinternmed.2011.220
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