nologies by incorporating basic information tools for consumers’ medication self-management.

MEDICATION SAFETY RESEARCH: INCIDENCE, COSTS, AND PREVENTION STRATEGIES

Incidence Rates

The committee examined the literature on incidence rates of medication errors. Despite the considerable research on incidence that has already taken place in certain areas, the committee believes much more such research needs to be carried out. In particular, it is important to characterize incidence rates by type and severity. Incidence rates are important for gauging the scope of the problem, for setting priorities for prevention strategies, and for measuring the impact of such strategies. The types of research required are described below for the hospital, nursing home, and ambulatory care settings; for pediatric and psychiatric care; and for the use of over-the-counter (OTC) and complementary and alternative medications.

Hospital Care

Medication error rates in hospitals have been relatively well researched. Thus the committee believes measurement of error rates in this care setting, with the exception of rates for specific populations (pediatric and psychiatric patients; see below), is not a priority for research. As indicated in Chapter 5, methods for detecting errors and ADEs can increasingly be built into electronic health records and other information systems, enabling better estimation of incidence rates for some types of errors and ADEs on an ongoing basis. Furthermore, these systems may be able to identify ADEs early enough in many situations to mitigate harm. However, research aimed at improving and standardizing these methods is a high priority.

Nursing Home Care

The long-term care arena is in need of a broad research agenda, including incidence data and the characterization of high-risk errors. There are more than 1.6 million residents of nursing homes in the United States. Levels of medication use are particularly high in these facilities, and patients are at particular risk for ADEs (Gurwitz et al., 2000, 2005). Recent studies have not focused specifically on medication errors, but have indicated that as many as half of all ADEs in the nursing home setting may be preventable. Nursing home residents taking antipsychotic medications,



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