Unsafe medication is a leading cause of harm, most of it preventable, in healthcare systems around the world. The World Health Organization (WHO) has initiated the third Global Patient Safety Challenge on Medication Safety to focus on improving medication safety by strengthening the systems for reducing medication errors and avoidable medication-related harm. The overarching goal is to reduce the level of severe, avoidable harm related to medications by 50 per cent, over five years, globally.

Medication safety issues can impact health outcomes, length of stay in a healthcare facility, readmission rates, and overall costs to Canada's healthcare system. Preventable medication hospitalizations cost over $140 million CAD in direct and indirect healthcare expenditures, with lost productivity, including time off work, adding $12 million in costs. Globally, the cost associated with medication errors has been estimated at over $55 billion. The Challenge aims to make improvements at each stage of the medication process, including prescribing, dispensing, administering, monitoring and use.

The Canadian Patient Safety Institute is leading the Medication Without Harm campaign in Canada. Over the course of the next five years, together with patients and partners, the Canadian Patient Safety institute will develop and execute an implementation plan, monitor and evaluate progress made and work closely with the WHO to ensure the long-term sustainability of strategies implemented over the course of the campaign. The Canadian Patient Safety Institute strategic plan, PATIENT SAFETY RIGHT NOW, calls for medication errors to be reduced by 50 per cent within five years.

Canadian Patient Safety Week, to be held October 29 to November 2, 2018, will focus on the medication safety to reduce medication errors across Canada. The theme, Not All Meds Get Along, prompts patients and healthcare practitioners to seek medication reviews for at-risk populations.

Patients over the age of 65 are at a higher risk of experiencing medication complications. Two out of three Canadians over the age of 65 take at least five different prescription medications, while 27 per cent take at least 10 different prescription medications. An estimated 37 per cent of seniors in nine provinces have received a prescription for a drug that should not be taken by this population. In 2016, one in 143 Canadians were hospitalized due to harmful effects from the medications they were taking. 

Medication reviews are recommended for anyone taking five or more medications; patients who have been recently discharged from hospital; and anyone who is concerned about the side effects they, or their loved ones are experiencing. Medication reviews can be completed by your healthcare provider, or pharmacist.

In collaboration with the Institute for Safe Medication Practices Canada (ISMP Canada), the Canadian Patient Safety Institute, Patients for Patient Safety Canada, the Canadian Pharmacists Association and the Canadian Society for Hospital Pharmacists a set of five questions has been developed to help patients and caregivers start a conversation about medications to improve communications with their healthcare provider. To increase spread and uptake, 5 Questions to Ask About Your Medications has been formally endorsed by over 70 organizations and regional health authorities for use within their organizations and the tool has been translated into 22 languages.

In another partnership with ISMP Canada, a national interactive webinar series has been developed to facilitate shared learning from medication incident analyses and safety initiatives. The Med Safety Exchange is a series of one-hour webinars  where frontline practitioners from Canadian healthcare organizations  share key learnings to encourage participants to identify similar vulnerabilities and safety opportunities in their own systems and contribute their own strategies for dealing with identified medication safety issues. The bi-monthly webinar series will continue into 2019.

In December 2017, Patients for Patient Safety Canada hosted a webinar on patient engagement in medication safety. This global webinar series was designed and facilitated by patient partners.

To address opioid safety and stewardship, the Canadian Patient Safety Institute, ISMP Canada and Patients for Patient Safety Canada are working to empower patients and improve their knowledge about the use of opioids and options for non-medication treatment of pain. Two new tools are now available, including an information card that provides guidance on the safe storage and disposal of opioids in the home. The second is a handout to assist patients who have recently been prescribed an opioid following surgery. Common questions are addressed to ensure that patients, families and caregivers have a thorough understanding of how to take these medications properly and safely. Work will continue to integrate opioid safety tools and resources to further empower patients to be aware and increase their knowledge about the use of opioids, including implementing dissemination strategies and tactics to address left-over and end-of life opioid supplies in the home.

A number of other initiatives are underway to support the challenge. These include the development of a Medication Safety Self-Assessment for High Alert Medications to help Canadian health organizations assess their safeguards and processes in managing high alert medications; and a safety improvement project, Medication Safety at Transitions of Care.  In addition, ongoing work relating to the challenge includes: supporting the outreach, education and feedback related to the implementation of the Protecting Canadians From Unsafe Drugs Act (Vanessa’s Law); supporting Health Canada’s ongoing work on a Drug Facts Table for Non-Prescription Drugs; and providing ongoing strategic guidance and support for the Canadian Mediation Incident Reporting and Prevention System (CMIRPS,) and to our partners -  ISMP Canada, the Canadian Institute for Health Information (CIHI) and Health Canada.

For more information, please contact info@cpsi-icsp.ca or medrec@ismp-canada.org