title: Incidence, causes, and consequences of preventable adverse drug events: protocol for an overview of reviews.
abstract: Medication errors represent a noteworthy source of harm to patients. In recent years, several systematic reviews have assessed the frequency and causes of these events, as well as other factors such as commonly associated drugs, their incidence in different specialties, and their consequences to patients. Despite this past literature, there remains a need to study discrepancies between these reviews and establish the current state of the evidence. The planned review will bring together, compare, and contract existing evidence related to the occurrence of medication errors in acute and continuing/long-term care settings.
  
  
  
  A systematic review of reviews will be performed. A literature search designed by an experienced information specialist will be carried out in Medline, Embase, and the Cochrane Library. We will seek systematic reviews and meta-analyses of primary research studies that evaluate one or more of the following aspects of the occurrence of preventable adverse drug events in hospitals and long-term care centers: the incidence of preventable adverse drug events, either overall or within subgroups of interest related to setting; drug or patient characteristics; cited consequences of these events to patients, including death, emergency room visits, or other outcomes; and established causes of the preventable adverse drug events. Two researchers will independently screen all abstracts and full texts for study selection and subsequently perform data extraction from all included studies. Quality of the reviews will be assessed using the assessing the methodological quality of systematic reviews (AMSTAR) tool. Where objectives from two or more reviews overlap, we will employ the Jadad framework to assess the causes of any noted discrepancies between reviews. An overall summary of results will be performed using tabular and graphical approaches and will be supplemented by narrative description.
  
  
  
  This overview will help synthesize the broad degree of information available on this important topic. This review is being performed by members of the Drug Safety and Effectiveness Network along with collaboration from Health Canada, and its findings will be published in a peer-reviewed journal. The results may also inform future research in this area.
  
  
  
  PROSPERO CRD42016043220.
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada. bhutton@ohri.ca.|School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada. bhutton@ohri.ca.
authors.forename: Brian
authors.identifier: 0000-0001-5662-8647
authors.initials: B
authors.lastname: Hutton
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada.|The Ottawa Hospital, Ottawa, Canada.
authors.forename: Salmaan
authors.initials: S
authors.lastname: Kanji
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada.|The Ottawa Hospital, Ottawa, Canada.
authors.forename: Erika
authors.initials: E
authors.lastname: McDonald
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Yazdi
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada.
authors.forename: Dianna
authors.initials: D
authors.lastname: Wolfe
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada.|School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada.|Institute of Clinical and Evaluative Sciences (ICES uOttawa), Ottawa, Canada.
authors.forename: Kednapa
authors.initials: K
authors.lastname: Thavorn
authors.affiliation: Health Canada, Marketed Health Products Directorate, Ottawa, Canada.
authors.forename: Sally
authors.initials: S
authors.lastname: Pepper
authors.affiliation: Health Canada, Marketed Health Products Directorate, Ottawa, Canada.
authors.forename: Laurie
authors.initials: L
authors.lastname: Chapman
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada.
authors.forename: Becky
authors.initials: B
authors.lastname: Skidmore
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada.|School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Moher
mesh_terms: D011307:Drug Prescriptions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D015994:Incidence; D050316:Medical Order Entry Systems; D055118:Medication Adherence; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D061214:Patient Safety / Q000592:standards; D012107:Research Design; D012196:Review Literature as Topic; D012307:Risk Factors; D000078202:Systematic Reviews as Topic
keywords: Adverse drug events; Adverse drug reactions; Medication errors; Overview of reviews; Systematic review