Systematic review and meta-analysis of community pharmacy error rates in the USA: 1993-2015

Patrick J. Campbell, Mira Patel, Jennifer R. Martin, Ana L. Hincapie, David Rhys Axon, Terri L. Warholak, Marion Slack

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Importance: While much is known about hospital pharmacy error rates in the USA, comparatively little is known about community pharmacy dispensing error rates. Objective: The aim of this study was to determine the rate of community pharmacy dispensing errors in the USA. Methods: English language, peer-reviewed observational and interventional studies that reported community pharmacy dispensing error rates in the USA from January 1993 to December 2015 were identified in 10 bibliographic databases and topic-relevant grey literature. Studies with a denominator reflecting the total number of prescriptions in the sample were necessary for inclusion in the meta-analysis. A random effects meta-analysis was conducted to estimate an aggregate community pharmacy dispensing error rate. Heterogeneity was assessed using the I2 statistic prior to analysis. Results: The search yielded a total of 8490 records, of which 11 articles were included in the systematic review. Two articles did not have adequate data components to be included in the meta-analysis. Dispensing error rates ranged from 0.00003% (43/1 420 091) to 55% (55/100). The meta-analysis included 1 461 128 prescriptions. The overall community pharmacy dispensing error rate was estimated to be 0.015 (95% CI 0.014 to 0.018); however, significant heterogeneity was observed across studies (I2 = 99.6). Stratification by study error identification methodology was found to have a significant impact on dispensing error rate (p<0.001). Conclusion and relevance: There are few published articles that describe community pharmacy dispensing error rates in the USA. Thus, there is limited information about the current rate of community pharmacy dispensing errors. A robust investigation is needed to assess dispensing error rates in the USA to assess the nature and magnitude of the problem and establish prevention strategies.

Original languageEnglish (US)
Article numbere000193
JournalBMJ Open Quality
Issue number4
StatePublished - Oct 1 2018


  • healthcare quality improvement
  • human error
  • medication safety
  • pharmacists

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Leadership and Management


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