Editorial: Medication safety and interventions to reduce patient harm in low- and middle-income countries

Abstract

The safe and rational use of medicines is crucial, especially from the context of low- and middle-income countries (LMICs) where medicine spending accounts for a considerable proportion of healthcare costs, and much of this is out-of-pocket expenditure (Cameron et al., 2009; Ofori-Asenso and Agyeman, 2016). Consequently, medicines should not be over-used or misused as seen with antibiotics in ambulatory care among patients with self-limiting illnesses or in hospitals for patients with COVID-19 (Godman et al., 2020; Langford et al., 2021), as this increases antimicrobial resistance (AMR) with its considerable impact on morbidity, mortality, and cost (Hofer, 2019; Antimicrobial Resistance Collaborators, 2022; GBD, 2023). Similarly, efforts are needed to improve medicine use in patients with chronic non-communicable diseases, including enhancing adherence to prescribed medicines, to improve outcomes and reduce complications (Kirk et al., 2017; Rezende Macedo do Nascimento et al., 2020; Chan et al., 2021; Nowak et al., 2022). Alongside this, reducing the potential for drug-drug interactions (DDIs) especially among patients with multiple co-morbidities. Furthermore, increased knowledge about possible adverse drug events (ADE) can reduce medication errors and adverse drug reactions (ADRs), with their substantial impact on morbidity, mortality and cost (Chan et al., 2016; Mouton et al., 2016; Formica et al., 2018). However, major issues with medication safety, including ADRs and medication errors, are severely hampered by inadequate patient education and counselling, low health literacy and considerable under reporting of ADRs (Mahmoud et al., 2014), with issues of medication misadventure more prevalent in LMICs. It was against this background, that the need for this Research Topic was identified, which resulted in 19 original research papers. It is hoped that this collection of original papers will provide future guidance to reduce patient harm, improve the care of patients and their quality-of-life.