Agreeing on global research priorities for medication safety: an international prioritisation exercise

Objectives: Medication errors continue to contribute substantially to global
morbidity and mortality. In the context of the recent launch of the World
Health Organization’s (WHO) Third Global Patient Safety Challenge: Medication
Without Harm, we sought to establish agreement on research priorities
for medication safety.

Methods: We undertook a consensus prioritisation exercise using an approach
developed by the Child Health and Nutrition Research Initiative.
Based on a combination of productivity and citations, we identified leading
researchers in patient and medication safety and invited them to participate.
We also extended the invitation to a further pool of experts from the
WHO Global Patient Safety Network. All experts independently generated
research ideas, which they then independently scored based on the criteria
of: answerability, effectiveness, innovativeness, implementation, burden reduction and equity. An overall Research Priority Score and Average Expert
Agreement were calculated for each research question.

Findings: 131 experts submitted 333 research ideas, and 42 experts then
scored the proposed research questions. The top prioritised research areas
were: (1) deploying and scaling technology to enhance medication safety;
(2) developing guidelines and standard operating procedures for high-risk
patients, medications and contexts; (3) score-based approaches to predicting
high-risk patients and situations; (4) interventions to increase patient medication literacy; (5) focused training courses for health professionals; and (6)
universally applicable pictograms to avoid medication-related harm. Whilst
there was a focus on promoting patient education and involvement across
resource settings, priorities identified in high-resource settings centred on
the optimisation of existing systems through technology. In low- and middle-
resource settings, priorities focused on identifying systemic issues contributing
to high-risk situations.

Conclusions: WHO now plans to work with global, regional and national
research funding agencies to catalyse the investment needed to enable teams
to pursue these research priorities in medication safety across high-, middle and
low-resource country settings.