ObjectivesTo provide an overview of whether the clinical decision support system (CDSS) was effective in reducing medication error and improving medication safety and to assess the quality of available scientific evidence.MethodsPubMed, EMbase, The Cochrane Library, CBM, WanFang Data, VIP and CNKI databases were electronically searched to collect systematic reviews (SRs) on application of clinical decision support system in the medication error and safety from January, 1996 to November, 2018. Two reviewers independently screened literature, extracted data and then evaluated methodological quality of included SRs by using AMSTAR tool.g AMSTAR tool.ResultsA total of 20 SRs including 256 980 healthcare practitioners and 1 683 675 patients were included. Specifically, 16 studies demonstrated moderate quality and 4 demonstrated high quality. 19 SRs evaluated multiple process of care outcome: 9 were sufficient evidence, 6 were limited evidence, and 7 were insufficient evidence which proved that CDSS had a positive effect on process outcome. 13 SRs evaluated reported patient outcomes: 1 with sufficient evidence, 3 with limited evidence, and 9 without sufficient evidence.ConclusionsCDSS reduces medication error by inconsistently improving process of care measures and seldom improving patient outcomes. Larger samples and longer-term studies are required to ensure a larger and more reliable evidence base on the effects of CDSS intervention on patient outcomes.
ObjectiveThis study aimed to characterize the adverse reactions related to medication errors (MEs) in pediatric population reported in the US Food and Drug Administration Adverse Event Reporting System (FAERS), and to identify the signals for different drug MEs. MethodsData from pediatric MEs reports in the FAERS from January 1, 2004, to December 1, 2022, were collected. MEs reports were categorized by patient age groups, MEs, and anatomical therapeutic chemical classification system. Disproportionality analyses were performed. ResultsA total of 16 515 MEs reports were retrieved. Psychostimulants and immunosuppressants were the most frequently reported drugs. Administration errors (72.4%) were most frequent, followed by prescription errors (7.1%) and storage errors (3.9%). In infants (1 year), ibuprofen and paracetamol were the most frequently reported, and MEs signals were found for dose and administration errors. In children (2-11 years), methylphenidate and somatropin recombinant were the most frequently reported, and MEs signals were found for dose omission and prescription errors. In adolescents (12-18 years), somatropin recombinant and adalimumab were the most frequently reported, and MEs signals were found for dose errors. ConclusionThis study systematically analyzed pediatric MEs reported in the FAERS database, identifying age-specific high-risk drugs and common error types, and noting that some high-frequency reports may be influenced by reporting mechanisms. Combined with domestic monitoring data and clinical practice experience, the findings highlight the need for age-targeted prescription review, pharmacist involvement, and medication education to reduce pediatric MEs and improve medication safety.