Maria Panagioti|Jonathan Stokes|Aneez Esmail|Peter Coventry|Sudeh Cheraghi?Sohi|Rahul Alam|Peter Bower
Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis
Manchester Academic Health Science Centre|University of Manchester|Manchester Academic Health Science Centre|University of Manchester|Manchester Academic Health Science Centre|University of Manchester|Manchester Academic Health Science Centre|University of Manchester|Manchester Academic Health Science Centre|University of Manchester|Manchester Academic Health Science Centre|University of Manchester|Manchester Academic Health Science Centre|University of Manchester
multimorbidity increasingly prevalent represents major challenge primary care patients multimorbidity potentially likely experience safety incidents due complexity needs frequency interactions health services however rigorous syntheses link patient safety incidents multimorbidity available review examined relationship multimorbidity patient safety incidents primary carewe followed published protocol prospero registration number crd42014007434 medline embase cinahl searched may 2015 study design quality assessed odds ratios 95 confidence intervals 95 cis calculated associations multimorbidity two categories patient safety outcomes active patient safety incidents adverse drug events medical complications precursors safety incidents prescription errors medication nonadherence poor quality care diagnostic errors metaanalyses using random effects models undertakeneighty six relevant comparisons 75 studies included analysis metaanalysis demonstrated physicalmental multimorbidity associated increased risk active patient safety incidents 239 95 ci 140 338 precursors safety incidents 169 95 ci 136 203 physical multimorbidity associated increased risk active safety incidents 163 95 ci 145 180 associated precursors safety incidents 102 95 ci 090 113 statistical heterogeneity high methodological quality studies generally lowthe association multimorbidity patient safety complex varies type multimorbidity type safety incident analyses suggest multimorbidity involving mental health may key driver safety incidents important implication design targeting interventions improve safety high quality studies examining mechanisms patient safety incidents patients multimorbidity needed goal promoting effective service delivery ameliorating threats safety group patients