Welcome to our latest series, "Optimizing Medication Safety in Primary Care & Outpatient Settings: An Interactive Series." This program is designed with the aim of supporting participants understand the root causes of medication safety incidents and then equipping them with essential knowledge and skills to prevent and mitigate errors, thereby enhancing patient care.

Course Description:  

Course Outline:  

The series is organized in the following manner:

• Webinar 1: April 22, 2024: Introduction to Medication Safety
• Webinar 2: May 20, 2024: Root Causes of and mitigation strategies for Medication Safety Issues
• Webinar 3: June 10, 2024: Medication Reconciliation
• Webinar 4: September 16, 2024: Polypharmacy and Deprescribing
• Webinar 5: October 21, 2024: High Risk Medication and Special Populations
• Webinar 6: November 25, 2024: Future Trends in Medication Safety

Course Objectives:

At the conclusion of this activity, participants will have gained an understanding of:

1. Outline the main concepts of medication safety
2. Analyze the root causes of medication errors and propose preventive measures
3. Construct ways to minimize the risk of polypharmacy in primary care
4. Outline risk factors for adverse drug events and medication errors
5. Outline strategies to reduce medication safety incidences at interfaces of care (admission, transfer and discharge)
6. Discuss the integration of emerging technologies and artificial intelligence in medication management

 

Target Audience:

Physicians, Allied Health Professionals, Dentists, Nurses, Pharmacists, Students

 

Needs Assessment:

Primary care providers play a critical role in ensuring patient safety and well-being, particularly concerning medication management. However, medication errors and adverse drug events, many of which are preventable, remain alarmingly common in primary care, with an estimated 50% of adverse drug events occurring in outpatient settings, posing significant risks to patient health¹.  It is estimated that one in ten patients are harmed whilst receiving care² and there is a wealth of evidence showing that quite often, the prescribing, dispensing and administration of medication by healthcare practitioners increase the risk of preventable patient harm^3-7.

The root causes include complexity of medication regimens due to comorbidities and polypharmacy, limited resources and time constraints to conduct thorough medication reviews and provide comprehensive patient education and a lack of interprofessional collaboration and communication, in some primary care settings.

In a study aimed at identifying the Continuing Professional Development (CPD) needs of community pharmacists in Qatar, participants were invited to self-assess their competency level in key pharmacy activities. Alarmingly, in a 3-point scale, none of the respondents thought they were competent in identifying actual or potential drug-related problems⁸. Another study aimed at understanding the perspectives of healthcare professionals in Qatar on causes of medication errors highlighted a reliance of doctors on pharmacists to correct their errors, a lack of recognition of nurses' roles as well as regular non-adherence to policy⁹.

These and other studies exploring the issue from both an international as well as a Qatar perspective highlighted the following¹⁰:

• Medication safety cuts across all disciplines involved in patient care and therefore, multi-disciplinary collaboration is required to resolve the problem.
• Education plays a fundamental role and leads to a significant reduction in errors and improved patient outcomes. 

This need is also expressed in Qatar National Health Strategy 2018–2022 (QNHS 2018–2022) and Qatar National Vision 2030 (QNV 2030) which aims at improving primary health-care services^11,12,13.

A survey was conducted by the course directors in 2022, to identify the specific gaps in Medication Safety in primary care in Qatar. The survey had a total of 192 respondents comprising of 151 pharmacists, 11 Physicians, 20 nurses and 6 Allied Health Care Professionals. Gaps were highlighted across a wide range of areas which were grouped by the course directors to be covered under the following key umbrella themes.

• Medicines reconciliation
• Polypharmacy and deprescribing
• Patient counselling
• “Look alike sound alike” medication
• Medication safety during Covid pandemic

A 4-hour interprofessional workshop aimed at optimizing medication safety focused on the above themes was developed. It was attended by 119 HCPs who provided the following feedback in the participant post activity evaluation survey.

• 76% strongly agreed/agreed that they obtained new knowledge
• 72% strongly agreed/agreed that the activity would impact their competence
• 60% strongly agreed/agreed that the activity would impact their performance in practice

The participants also recommended ongoing CPD activities focusing on medication safety optimization and made some recommendation of themes to focus on including medicines reconciliation, polypharmacy, high risk medication and future trends.

A follow up survey sent to participants 2 months after the activity highlighted that 42% changed their clinical practice as a result of attending the workshop.

The literature and above survey results highlight the urgent need for a CPD series focused on optimizing medication safety in primary care. By addressing the identified needs, the CPD series aims to empower primary care HCPs with the knowledge, skills, and resources necessary to enhance medication safety practices and improve patient outcomes.

References

1. Gandhi TK, Weingart SN, Borus J, et al. Adverse drug events in ambulatory care. N Engl J Med. 2003;348(16):1556-1564.

2. Jha AK, Larizgoitia I, Audera-Lopez C, Prasopa-Plaizier N, Waters H, Bates DW. The global burden of unsafe medical care: analytic modelling of observational studies. BMJ Qual Saf 2013; 22:809–15. https://doi.org/10.1136/bmjqs-2012-001748 PMID: 24048616

3. Lewis PJ, Dornan T, Taylor D, Tully MP, Wass V, Ashcroft DM. Prevalence, incidence and nature of prescribing errors in hospital inpatients. Drug Saf 2009; 32:379–89. https://doi.org/10.2165/00002018- 200932050-00002 PMID: 19419233

4. Ross S, Bond C, Rothnie H, Thomas S, Macleod MJ. What is the scale of prescribing errors committed by junior doctors? A systematic review. Brit J Clin Pharmacol 2009; 67:629–40.

5. James KL, Barlow D, McArtney R, Hiom S, Roberts D, Whittlesea C. Incidence, type and causes of dispensing errors: a review of the literature. Int J Pharm Pract 2009; 17(1):9–30. PMID: 20218026

6. Franklin BD, Reynolds M, Shebl NA, Burnett S, Jacklin A. Prescribing errors in hospital inpatients: a three-centre study of their prevalence, types and causes. Postgrad Med J 2011; 87:739–45. https://doi. org/10.1136/pgmj.2011.117879 PMID: 21757461

7. Keers RN, Williams SD, Cooke J, Ashcroft DM. Prevalence and nature of medication administration errors in health care settings: a systematic review of direct observational evidence. Ann Pharmacother 2013; 47:237–56. https://doi.org/10.1345/aph.1R147 PMID: 23386063

8. Al-Sulait F, Fares H, Awaisu A, Nadir Kheir N. Continuing Professional Development Needs of Community Pharmacists in Qatar: A Mixed-Methods Approach.  International Quarterly of Community Health Education 2021, Vol. 41(3) 285–292

9. Stewart D et al. Perspectives Perspectives of healthcare professionals in Qatar on causes of medication errors: A mixed methods study of safety culture. PLoS One2018 Sep 28;13(9):e0204801.doi: 10.1371/journal.pone.0204801. eCollection 2018. Available on https://pubmed.ncbi.nlm.nih.gov/30265732/

10. J. Cleary-Holdforth, T. Leufer. The strategic role of education in the prevention of medication errors in nursing: part 2. 2013.Nurse education in practice. Available on https://www.semanticscholar.org/paper/The-strategic-role-of-education-in-the-prevention-Cleary-Holdforth-Leufer/36e60f28274c876435a5891264949ff75ee48fa1

11. Kheir N, Zaidan M, Younes H, et al. Pharmacy education and practice in 13 Middle Eastern countries. Am J Pharm Educ. 2008;72(6):133.

12. General Secretariate Development Planning. Qatar National Vision (QNV) 2030 Doha, Qatar Qatar Government Communications Office 2008 [cited 2019 11 November] . Available from: https://www.gco.gov.qa/en/about-qatar/nation al-vision2030/.

13. Qatar National Health Strategy 2018-2022, (2018). https:// www.moph.gov.qa/english/strategies/National-HealthStrategy-2018-2022/Pages/default.aspx