Medicine self-administration errors in the older adult population: A systematic review

Background: Medicine self-administration errors (MSEs) are a longstanding issue in patient safety. Although many studies have examined MSEs in the general adult population, the MSEs that occur specifically in the older adult population and their contributing factors are not well understood. Objective: To identify the types of MSEs and their contributing factors among community-dwelling older adults. Methods: PubMed, Medline, Embase, CINAHL and Scopus were searched for primary studies published between January 1, 2014 and June 12, 2020. Studies which reported MSEs among community-dwelling older adults (>= 50 years of age) and written in English were included in the review. Results: Eleven studies met the inclusion criteria. The most commonly reported MSE was a dosing error, followed by missed dose, wrong medicine, incorrect administration methods, wrong administration time and wrong frequency. Seven of the included studies also described factors which contributed to the occurrence of MSEs. The most commonly reported factor contributing to MSEs was complex treatment regimens due to use of multiple medicines. Other factors identified included cognitive decline, decline in physical abilities, lack of social support, lack of knowledge about treatment regimens and negative attitudes and beliefs towards medicines. In most cases, MSEs occurred when multiple contributing factors were present. Conclusion: The literature highlights a number of types of MSEs and their contributing factors which occur in the older adult population. Given that many MSEs are preventable, future research is needed into how pharmacists can support the identification and mitigation of factors contributing to MSEs in the older adult population.