Evidence mapPaperPMID 35641040Full record

SynthesisJournal of the American Board of Family Medicine : JABFM

Ambulatory Medication Safety in Primary Care: A Systematic Review.

Richard A Young, Kimberly G Fulda, Anna Espinoza, Ayse P Gurses, Zachary N Hendrix, Timothy Kenny, Yan Xiao

Open access · diamondAbstract readSystematic Review
In one paragraph

Synthesis in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 20 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Co-Design with Patients for Improving Patient Safety: Strategies, Barriers and pitfalls.Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting. Human Factors and Ergonomics Society. Annual meeting · 2023
    Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Richard A YoungFrom JPS Hospital Family Medicine Residency Program, Fort Worth, TX (RAY); Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network, University of North Texas Health Science Center, Fort Worth, TX (KGF, AE); Armstrong Institute Center for Health Care Human Factors, School of Medicine, Bloomberg School of Public Health, Malone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University (APG); University of Texas at Arlington, Arlington, TX (ZNH); Maine Medical Center, Portland, ME (TK); College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX (YX). ryoung01@jpshealth.org.
Kimberly G FuldaFrom JPS Hospital Family Medicine Residency Program, Fort Worth, TX (RAY); Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network, University of North Texas Health Science Center, Fort Worth, TX (KGF, AE); Armstrong Institute Center for Health Care Human Factors, School of Medicine, Bloomberg School of Public Health, Malone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University (APG); University of Texas at Arlington, Arlington, TX (ZNH); Maine Medical Center, Portland, ME (TK); College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX (YX).
Anna EspinozaFrom JPS Hospital Family Medicine Residency Program, Fort Worth, TX (RAY); Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network, University of North Texas Health Science Center, Fort Worth, TX (KGF, AE); Armstrong Institute Center for Health Care Human Factors, School of Medicine, Bloomberg School of Public Health, Malone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University (APG); University of Texas at Arlington, Arlington, TX (ZNH); Maine Medical Center, Portland, ME (TK); College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX (YX).
Ayse P GursesFrom JPS Hospital Family Medicine Residency Program, Fort Worth, TX (RAY); Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network, University of North Texas Health Science Center, Fort Worth, TX (KGF, AE); Armstrong Institute Center for Health Care Human Factors, School of Medicine, Bloomberg School of Public Health, Malone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University (APG); University of Texas at Arlington, Arlington, TX (ZNH); Maine Medical Center, Portland, ME (TK); College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX (YX).
Zachary N HendrixFrom JPS Hospital Family Medicine Residency Program, Fort Worth, TX (RAY); Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network, University of North Texas Health Science Center, Fort Worth, TX (KGF, AE); Armstrong Institute Center for Health Care Human Factors, School of Medicine, Bloomberg School of Public Health, Malone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University (APG); University of Texas at Arlington, Arlington, TX (ZNH); Maine Medical Center, Portland, ME (TK); College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX (YX).
Timothy KennyFrom JPS Hospital Family Medicine Residency Program, Fort Worth, TX (RAY); Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network, University of North Texas Health Science Center, Fort Worth, TX (KGF, AE); Armstrong Institute Center for Health Care Human Factors, School of Medicine, Bloomberg School of Public Health, Malone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University (APG); University of Texas at Arlington, Arlington, TX (ZNH); Maine Medical Center, Portland, ME (TK); College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX (YX).
Yan XiaoFrom JPS Hospital Family Medicine Residency Program, Fort Worth, TX (RAY); Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network, University of North Texas Health Science Center, Fort Worth, TX (KGF, AE); Armstrong Institute Center for Health Care Human Factors, School of Medicine, Bloomberg School of Public Health, Malone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University (APG); University of Texas at Arlington, Arlington, TX (ZNH); Maine Medical Center, Portland, ME (TK); College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX (YX).
John Peter Smith Hospital · USThe University of Texas at Arlington · USJohns Hopkins University · USResearch Network (United States) · USUniversity of North Texas · US

Funding

AHRQ HHS R18 HS027277EPA EP-D-18-001
6 · The paper itself

Abstract

purposeTo review the literature on medication safety in primary care in the electronic health record era.

methodsIncluded studies measured rates and outcomes of medication safety in patients whose prescriptions were written in primary care clinics with electronic prescribing. Four investigators independently reviewed titles and analyzed abstracts with dual-reviewer review for eligibility, characteristics, and risk of bias.

resultsOf 1464 articles identified, 56 met the inclusion criteria. Forty-three studies were noninterventional and 13 included an intervention. The majority of the studies (30) used their own definition of error. The most common outcomes were potentially inappropriate prescribing/medications (PIPs), adverse drug events (ADEs), and potential prescribing omissions (PPOs). Most of the studies only included high-risk subpopulations (39), usually older adults taking > 4 medications. The rate of PIPs varied widely (0.19% to 98.2%). The rate of ADEs was lower (0.47% to 14.7%). There was poor correlation of PIP and PPO with documented ADEs leading to physical harm.

conclusionsThis literature is limited by its inconsistent and highly variable outcomes. The majority of medication safety studies in primary care were in high-risk populations and measured potential harms rather than actual harms. Applying algorithms to primary care medication lists significantly overestimates rate of actual harms.

Indexed as

Drug-Related Side Effects and Adverse ReactionsInappropriate PrescribingAgedAmbulatory Care FacilitiesHumansPotentially Inappropriate Medication ListPrimary Health CareAdverse Drug EventsElectronic PrescribingFamily MedicineMedication SafetyPrimary Health CareSystematic Review

Identifiers

PMID35641040
PMCPMC9730343
OpenAlexW4281969364

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.