title: Measuring experiences and outcomes of patient safety in primary care: a systematic review of available instruments.
abstract: BACKGROUND
  Despite the enormous potential for adverse events in primary care, the knowledge base about patient safety in this context is still sparse. The lack of appropriate measurement methods is a key factor limiting the development of research in this field.
  
  
  OBJECTIVE
  To identify and characterize available patient reported instruments to measure patient safety in primary care.
  
  
  METHODS
  We conducted a systematic literature review. We searched in bibliographic sources for empirical studies describing the development, evaluation or use of patient reported instruments assessing patient safety in primary care. Study selection and data extraction were independently conducted by two researchers.
  
  
  RESULTS
  We identified 28 studies reporting on 23 different instruments. Fifteen instruments were designed for paper-based self-administration, six for phone interview and two consisted in electronic reporting systems. Most instruments focused on specific aspects of patient safety, most commonly on experiences of adverse drug reactions. Face validity was assessed for 10 instruments (43%), three reported construct validity (13%) and three described reliability (13%). Responsiveness was not ascertained.
  
  
  CONCLUSIONS
  Although there is evidence of good psychometric properties for a reduced number of patient reported instruments, currently available instruments do not offer a comprehensive set of resources to measure the effects of interventions to improve patient safety in primary care from a patient perspective. Future research in the field should prioritize (i) the evaluation of the performance of already available instruments and (ii) the development of new instruments that enable an comprehensive assessment of patient safety at general practices.
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK, ignacio.riccicabello@phc.ox.ac.uk.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ricci-Cabello
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
authors.forename: Daniela C
authors.initials: DC
authors.lastname: Gonçalves
authors.affiliation: Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Barcelona, Spain and.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rojas-García
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK, Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Valderas
mesh_terms: D006801:Humans; D063868:Patient Outcome Assessment; D061214:Patient Safety; D011320:Primary Health Care; D011594:Psychometrics; D015203:Reproducibility of Results
keywords: Health services research; patient experiences; patient reported outcomes; patient safety; primary care; systematic literature review.