The Impact of Pharmacist Interventions on Reducing Medication Errors in Pediatric Patients: A Systematic Review and Meta-analysis

Abstract

Background: Medication errors are avoidable events that could occur at any stage of the medication use process. They are widespread in the healthcare system and are associated with increased risk of morbidity and mortality. Implementing a clinical pharmacist is one strategy that is believed to reduce medication errors in the general population including pediatric patients who are more vulnerable to medication errors due to several contributing factors including the challenges of weight-based dosing. Aim: The aim of this study is to qualitatively and quantitatively evaluate the impact of clinical pharmacist interventions on medication error rates for hospitalized pediatric patients. Methodology: PubMed, Embase, Cochrane and Google Scholar search engines were searched from database inception to February 2019. Study selection, data extraction and quality assessment was conducted by two independent reviewers. Observational and interventional studies were included. Data extraction was done manually and the Crowe Critical Appraisal Tool (CCAT) was used to critically appraise eligible articles. Summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model for rates of medication errors. Results: A total of 19 studies were systematically reviewed and 6 studies (29 291 patients) were included in the meta-analysis. Pharmacist interventions involved delivering educational sessions, reviewing prescriptions, attending rounds and implementing a unit-based clinical pharmacist. The systematic review showed that the most common trigger for pharmacist interventions was inappropriate dosing. Pharmacist involvement was associated with significant reductions in the overall rate of medication errors occurrence (OR, 0.27; 95% CI, 0.15 to 0.49). Conclusions: The most common cause for pharmacist interventions in pediatric patients at hospital settings was inappropriate dosing. Overall, pharmacist interventions are effective at reducing medication error rates