Patient-related risk factors for self-reported medication errors in hospital and community settings in 8 countries

Background: Medication errors can cause substantial harm to patients and may lead to significant costs within a health care system. As such, there is value in identifying patient-related risk factors for medication errors. The objectives of this study were to identify patient-related risk factors associated with self-reported medication errors and to determine whether the risk factors differed between hospital and community settings. Methods: The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in 8 countries was the primary data source. Univariate analyses were used to determine significant explanatory variables (p < 0.05) for inclusion in weighted logistic regression models. Two regression models were developed: one to identify overall patientrelated risk factors and the other to determine whether these factors differed between hospital and community settings. Results: The final study population consisted of 9944 adults. Patient-related risk factors significantly associated with self-reported medication errors were the number of medications being taken, sex, age and country of residence. Approximately 4 out of every 5 self-reported medication errors occurred in the community setting. Conclusions: A substantial percentage of patients with chronic diseases in the countries covered by the survey experienced medication errors, with most errors occurring in the community setting. Several patientrelated risk factors were associated with these errors. Greater emphasis on national incident reporting systems and greater sharing of knowledge across nations could help to identify strategies to overcome these problems. More specifically, strategies to increase reporting of and learning from medication errors, as well as education about potential patient-related risk factors, are recommended.