A scoping review of non-professional medication practices and medication safety outcomes during public health emergencies. (January 2023)

• Record Type: Journal Article
• Authors: Kelly, Dervla; Koay, Aaron; Mineva, Gabriela; Volz, Monika; McCool, Aoibhin; McLoughlin, Eavan; Ó Conluain, Ruán; Sharma, Manuj; Kerr, Aisling; Franklin, Bryony Dean; Grimes, Tamasine
• Is Part Of: Public health. Volume 214(2023)
• Page Start: 50
• Page End: 60
• Publication Date: 2023-01
• Subjects: Medication safety -- Public health emergency -- Medication-related harm -- Medication adherence; Public health -- Periodicals; Public health -- Periodicals; Electronic journals; 362.1
• DOI: 10.1016/j.puhe.2022.10.026
• Languages: English
• ISSNs: 0033-3506

Abstract

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.