Strategies and Activities for Improving Medication Safety in the NHS Scotland: Narrative Review and Possible Adaptations for Sri Lankan System

Background: Medication errors are the leading cause of preventable patient harm globally, and countries have adapted multiple strategies to prevent them.  
Objective: To explore the systems, strategies, and activities of medication safety applied at the National Health Service (NHS) in Scotland to compare them and consider what could be adapted to improve medication safety in Sri Lanka.
Methods: The RAMESES (Realist And Meta-narrative Evidence Syntheses) was followed and literature search was conducted in Google, Google Scholar, and PubMed with the terms “Medication Errors,” “Medication Safety” and “strategy,” “interventions.”, to identify studies and programs published from 2010 to 2022 that examined strate-gies and activities for improving medication safety in NHS Scotland.
Results: After screening, 45 sources were selected and an initial content analysis, followed by thematic analy-sis, was performed. The data were presented in nine broad themes: systems-based approaches to ensure safer use of medicines, strategies to promote reporting of medication incidents and adverse drug reactions, strategies to improve electronic prescribing, strategies to prevent medication harm due to high-risk medicines, providing clinical pharmacy services, strategies to improve information transfer, strategies to prevent medication harm due to polypharmacy, strategies to improve safe medication administration, and strategies to improve staff education.
Conclusions and Recommendations: NHS Scotland has implemented multiple, resource intensive strategies mainly utilizing information and communication technology (ICT) to improve medication safety. As a developing country, Sri Lanka can learn from these innovations but has implemented and planned to implement several strategies within resource constraints, which can be exemplary to any low- and middle-income country (LMIC).