Beneath a fine abstract from a presentation at the Second Global Ministerial Summit on Patient Safety :
Medication Safety in Resource-limited Settings
Priyadarshani Galappatthy, Prof. Dr., Faculty of Medicine, University of Colombo, Professor and Head Department of Pharmacology, Sri Lanka
Abstract: Medication safety is a major concern contributing to patient safety particularly in resource-limited settings (RLS). Absence of reliable estimates of prevalence of adverse drug events, costs involved, causes of medication errors and evidence of effective interventions in RLS is a major limiting factor for ensuring medication safety in RLS.
Although there are nearly five times as many people living in Lower and Middle Income Countries (LMICs), the number of annual adverse drugs events calculated (6 million) is almost equal to the number of adverse drug events occurring in high income countries (5.8 million). Some key problems identified include lack of reliable data, safety culture, reporting systems, poor reporting, poor legibility of hand written prescriptions, absence of electronic support systems, limited number of healthcare professionals to serve the large numbers of patients, lack of clinical pharmacists services, higher prevalence of counterfeit and substandard medicines (up to 20-30% in some LMIC countries), availability of large numbers of generics of the same drug, lack of stringent drug regulatory mechanisms, poor medication literacy and absence of patient support mechanisms.
Possible interventions include identification of the baseline situation on epidemiology and causes of adverse drug events in RLS, the drugs involved in RLS, their severity, amenability of drug events to prevention, implementing routine quality testing of drugs throughout the drug supply chain, implementing successful national drug regulation, increasing the capacity of regulators and providing technological support and expertise for detecting and managing drug related issues.
Expected outcomes would be establishing the baseline on the epidemiology of medication incidents in RLS, implementing systems and practices for medication safety and significant reduction in medication errors (e.g. up to 50%) in the next 5 years. Future direction is towards a multidisciplinary approach with active involvement of all stakeholders in preventing medication incidents. Developing and implementing an individualized action plan for each country for the problems identified based on local data would be the key to ensuring medication safety in RLS.
Keywords: medication safety, medication errors, resource limited settings, lower-middle income countries, prevention
Speaker Information: Priyadarshani Galappatthy is a consultant physician, professor in Pharmacology and Head, Department of Pharmacology, Faculty of Medicine, University of Colombo, Sri Lanka.
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