A scoping review of non-professional medication practices and medication safety outcomes during public health emergencies

Dervla Kelly; Aaron Koay; Gabriela Mineva; Monika Volz; Aoibhin McCool; Eavan McLoughlin; Ruán Ó Conluain; Manuj Sharma; Aisling Kerr; Bryony Dean Franklin; Tamasine Grimes

doi:10.1016/j.puhe.2022.10.026

A scoping review of non-professional medication practices and medication safety outcomes during public health emergencies

Public Health. 2023 Jan:214:50-60. doi: 10.1016/j.puhe.2022.10.026. Epub 2022 Dec 13.

Authors

Affiliations

¹ School of Medicine, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
² School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
³ School of Medicine, University of Limerick, Limerick, Ireland.
⁴ School of Medicine, Trinity College Dublin, Dublin, Ireland.
⁵ Research Department of Primary Care and Population Health, University College London, London, UK.
⁶ School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK.
⁷ Imperial College Healthcare NHS Trust, London, UK; NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, UK; UCL School of Pharmacy, London, UK.
⁸ School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland. Electronic address: tagrimes@tcd.ie.

PMID: 36521272
DOI: 10.1016/j.puhe.2022.10.026

Abstract

Objectives: Public health emergencies (PHE) can disrupt personal medication practices and increase the risk of medication-related harm and other negative medication-related outcomes. Our aim was to examine the extent and nature of published research on this topic to guide future research and practice.

Study design: Scoping review.

Methods: Standard electronic databases were searched. PRISMA-ScR guidelines were followed. Extracted data were organised in response to review questions and narrative accounts developed.

Results: A total of 129 studies were included, conducted across 32 countries, mostly in the USA (n = 42). Sixty-eight (53%) reported on infectious events, 49 (39%) climatological or ecological events and the remainder a mixture of terrorism, war or other disasters. The studies described several medication safety outcomes (medication-related harm, adherence, supply) and adaptive medication practices (self-altering prescribed medications, sharing medications and changing healthcare providers). Challenges to maintaining routine medication practices during a PHE included transport, finance, quarantine and knowledge-related issues. Twenty-eight studies (22%) examined health inequalities pertaining to adverse medication-related outcomes, with findings suggesting that gender, age, ethnicity, educational and socio-economic status may be related to inequalities. Research gaps identified included carers', children's and minority communities' experiences and intervention studies.

Conclusions: There is considerable evidence of disruptions to routine personal medication practices during PHEs and of medication-related harm and other negative outcomes. Maintaining medication supply for the management of chronic conditions is a universal problem across all emergency types. Research is needed to address these disruptions, particularly amongst people who experience health inequalities who may need additional support.

Keywords: Medication adherence; Medication safety; Medication-related harm; Public health emergency.

Publication types

Review

MeSH terms

Child
Chronic Disease
Emergencies*
Humans
Medication Adherence
Public Health*