Developing National Level High-alert Medication Lists for Community/primary Care Patients

Abstract

Despite the fact that a considerable number of preventable adverse events are managed in primary care settings, medication-related risks have been evaluated mainly through hospital admissions. While interest in high-alert medication management in the community and primary care settings is increasing internationally, Korea does not have accreditation for the same and lacks established standards for high-alert medications. Therefore, this study aimed to develop a nationallevel list of high-alert medications for community and primary care. The candidates for the high-alert medication list included medications recommended by Institute for Safe Medication Practices and those suggested by each guideline of the World Health Organization, Japan and Korea. We analyzed the adverse events related to medication errors reported by the patients' safety reporting system. Seven experts working in the community and primary care settings evaluated the adequacy and priority of the candidate medications. The final list included 20 high-alert medications, including nine essential and eleven optional medications. The national-level list of high-alert medications which we developed may be useful in formulating accreditation guidelines or treatment standards for community and primary care patients.