Patient harm due to unsafe care is a leading cause of death and disability worldwide, and most of such harm is avoidable (1). Harm due to medicines and therapeutic options accounted for nearly 50% of the overall preventable harm in medical care (2). The pooled prevalence of preventable medication-related harm was 5% (1 in 20 patients) and one fourth of the harm was severe or potentially life-threatening (3). The prevalence of preventable medication-related harm was nearly double, 7% (1 on 25 patients) in low- and middle-income countries (LMICs) compared to 4% (1 in 14 patients) in high-income countries.

This policy brief defines key concepts of medication safety and presents current evidence on the scale of the problem and the urgency of the situation. Medication errors occur throughout the medication use process; however, many recent studies indicate that most errors occur during prescribing and monitoring stages (3, 4). Evidence of medication-related harm in several contexts and environments are discussed.

Policy options with benefits, advantages and opportunities to improve medication safety are suggested, including technological solutions. Establishment of medication safety committees within the organizational structure, appointing medication safety or patient safety officers and implementing national action plans on medication safety are recommended. Ensuring a culture of safety and managing changes to the culture in the workplace and in the health care system are important to improve medication safety. Reporting and learning systems for medication errors have been used in countries to identify errors, creating learning opportunities for preventing errors.

Methods for addressing the priorities identified in the third WHO Global Patient Safety Challenge: Medication Without Harm are discussed using the strategic framework, focussing on the four domains and the three key action areas. Solutions that could be used in countries are proposed under the four domains of the strategic framework: the patient and the public, health and care workers, medicines as products, and systems and practices of medication and the three action areas: high-risk situations, polypharmacy and transitions of care.