title: Determinants of patient-reported medication errors: a comparison among seven countries.
abstract: OBJECTIVE
  Medication errors are a frequent cause of adverse drug events and a major concern for patient safety. This study compared the predictors of error among seven countries (Australia, Canada, New Zealand, the United Kingdom, the United States, Germany and the Netherlands).
  
  
  METHODS
  We conducted a cross-sectional study using the 2007 Commonwealth Fund International Health Policy Survey data. The outcome was patient-reported error in the past 2 years. Possible predictors were studied using logistic regression.
  
  
  RESULTS
  Eleven thousand nine hundred and ten respondents were included in this analysis, of which 1291 respondents (11%) had experienced error. Poor coordination of care was a shared concern of all seven countries [adjusted odds ratios (ORs) ranged from 2.1 (95% CI: 1.3-3.5) to 3.0 (95% CI: 2.1-4.5)]. Cost-related barriers to medical services/medicines was also a predictor in six countries [ORs ranged from 1.9 (95% CI: 1.5-2.6) to 2.6 (95% CI: 1.5-4.6)]. Other common risk factors across countries included seeing multiple specialists, multiple chronic conditions, hospitalisation and multiple emergency room visits. Cross-country heterogeneity in contributing factors included age and specific chronic condition. Number of medications, number of doctor visits, household income and education level were not associated with error in most countries.
  
  
  CONCLUSIONS
  Poor coordination of care is a key risk factor in all seven countries. Cost-related barriers were also associated with an increased likelihood of error. The major challenge for all countries for error prevention is better communication among multiple healthcare providers and more structured organisation of care across healthcare settings.
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. christine_lu@harvardpilgrim.org
authors.forename: C Y
authors.initials: CY
authors.lastname: Lu
authors.forename: E
authors.initials: E
authors.lastname: Roughead
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044362:Australasia; D003142:Communication; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D009656:North America; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000706:statistics & numerical data; D057566:Self Report; D055815:Young Adult