Plain Language Summary by Antony Chuter and Rachel Elliott

Paper: Economic Evaluations of Medication Safety Interventions in Primary and Long-Term Care: A Systematic Review, published in PharmacoEconomics on 29 November 2025.

What was the question?

Medicines are very effective at treating a lot of illnesses, such as high blood pressure, but sometimes mistakes are made, and people might get the wrong medicine, wrong dose or at the wrong time. For example, giving ibuprofen to a person with heart failure can sometimes make their heart failure worse and they may have to go to hospital.

There is a lot of work being done to reduce these “medication errors” in primary care. Some of the services developed do reduce the chance people experience a medication error, but the cost of these services is not always clear.

We wanted to find out what works to improve medication safety in primary care (general/family practice), community pharmacy and care homes, and how much does it cost?

What did we do?

We looked for published studies in medical journal databases. We included studies if they were:

1. In primary care (general/family practice), community pharmacies or care homes, and
2. Testing to see if a service made medicines safer for patients, and
3. Measuring medication errors or patient harm (such as an unplanned hospitalisation), and
4. Measuring how much it all costs

We checked the quality of each study we included. We worked with doctors, pharmacists and patients to make sure we asked the right questions and included the right studies.

What did we find?

We found 44 studies, published between 2004 and September 2025. Most studies were from the United States (13 studies), followed by the United Kingdom (11studies).

Twenty-two studies were conducted in general/family practice, 11 studies in community pharmacy, and 11 in care homes. The most common patient group targeted was people over 65 (24 studies).

The most common type of service was a medication review done by a pharmacist (24 studies). Nearly all the studies targeted prescribing and monitoring medicines. Very few looked improving safety of dispensing or giving medicines to patients.

Most studies didn’t include non-healthcare costs, such as patient costs.

Of 44 studies, 34 showed the services being looked at were cost-saving or cost-effective. However, some studies had some problems with their design, which makes it more difficult to use their results. There was very little patient or public involvement around targeting patient groups in need, or designing services.

What this means for patients and communities

• Our review highlights some cost-effective services to make medicines safer for patients in primary care, such as pharmacists looking for specific medication error information in electronic health records (such as prescribing ibuprofen in heart failure).
• Most services focused on prescribing errors and overlooked other aspects of the medicines use process (such as giving medicines to patients).
• The review identified little work on how technology developments, such as apps, could improve medication safety in a cost-effective way.

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