[21] A few studies have estimated the preventability of medication errors in primary care.[22–30] In the UK, approximately 5% admissions to secondary care have taken their roots from preventable drug-related problems at an estimated cost of over

£750 million per year to the NHS.[7] A healthcare system, with safety and quality at its heart, is therefore expected to capture errors, and most importantly, prevent reoccurrence. System thinking has underpinned successful investigations into suboptimal patient care – the events of the Bristol Royal Infirmary in the UK sparked an investigation, which focused Doxorubicin purchase on evaluations of the system rather than the events in isolation.[10] Most error studies, however, focus on individual points within the medicines management system, instead of adopting critical and holistic evaluations of the whole system of the use of medicines.[8] Similarly, BTK inhibitors high throughput screening interventions have often concentrated on improving individual parts of the system. For instance, automation in hospital pharmacies has aimed at improving the dispensing process,[31] even though other parts of the system may also benefit from some form of automation. This individualistic approach fails to recognise that errors are indeed the results of the systems that produce them and does not provide information on the relationship between

the units that make up the system.[21,32] To date, there have been few systematic reviews to appraise the safety of the entire medication

use system in primary care across healthcare systems. This paper reviewed the existing literature on the incidence of medication errors in primary care across the entire medicines management system. The objectives were: To appraise studies addressing medication error rates in primary care: To report error rates at each point of the system To appraise the methods used to identify errors in the studies To identify of the most susceptible Cediranib (AZD2171) points and patient groups To compare error rates between healthcare settings, and To identify studies on interventions to prevent medication errors in primary care. Electronic databases of MEDLINE, International Pharmaceutical Abstracts, Embase, PsycINFO, PASCAL (searched together on Wolters Kluwer/OVID SP platform in the British Library (BL)), Science Direct, Scopus, Web of Knowledge and CINAHL PLUS were searched. The choice of databases was based on the BL resources in Medicine and Healthcare, University of Hertfordshire Medicines-related database recommendations, and relevant publications. Reference lists of retrieved articles and relevant review articles were checked manually for further relevant studies. An initial scoping review retrieved 2530 hits after removal of 450 duplicates.