Guideline adherence for controlling incidence of medication errors: a systematic mixed-method review

Background: The article reviews the factors that affect healthcare professionals’ adherence to safe medication therapy guidelines, which are important for patient safety and quality of care. The purpose of this review was to further our knowledge on the factors and interventions that contribute to medication guideline adherence among healthcare professionals. Methods: This review employed a systematic, mixed-methods approach. The authors searched five databases for mixed studies (qualitative, quantitative, and mixed methods) from 2011 to 2023 and appraised them using the Mixed Methods Assessment Tool (MMAT). They extracted and synthesized the data using narrative synthesis. Results: We identified 20 studies that met the inclusion criteria. We found that the factors influencing medication guideline adherence vary by the roles and settings of healthcare professionals. We classified these factors into four categories: guideline level, personnel level, system level, and leadership level. Guideline-level factors refer to the clarity and consistency of the medication guidelines, policies, or protocols. Personnel-level factors involve the behavior, education, and practice of healthcare professionals. System-level factors relate to the institutional and systemic aspects that support and maintain medication guideline adherence. Leadership-level factors concern the planning and management of medication guideline implementation by healthcare managers. We also discussed the interventions that can improve guideline adherence, including (i) educational programs, (ii) pharmacist-based interventions, and (iii) computerized prescribing programs. Conclusion: This review provides a typology of factors to help organizations enhance medication safety adherence. The findings highlight the important role of hospital pharmacists in building multifaceted and multidisciplinary programs to address guideline adherence issues.