A systematic literature review on strategies to avoid look-alikeerrors of labels

AbstractPurpose Unclear labeling has been recognized as an important cause of look-alike medication errors. The aim of this literaturereview is to systematically evaluate the current evidence on strategies to minimize medication errors due to look-alike labels.Methods A literature search of PubMed and EMBASE for all available years was performed independently by two reviewers.Original studies assessing strategies to minimize medication errors due to look-alike labels focusing on readability of labels byhealth professionals or consumers were included. Data were analyzed descriptively due to the variability of study methods.Results Sixteen studies were included. Thirteen studies were performed in a laboratory and three in a healthcare setting.Eleven studies evaluated Tall Man lettering, i.e., capitalizing parts of the drug name, two color-coding, and three studiesother strategies. In six studies, lower error rates were found for the Tall Man letter strategy; one showed significantlyhigher error rates. Effects of Tall Man lettering on response time were more varied. A study in the hospital setting did notshow an effect on the potential look-alike sound-alike error rate by introducing Tall Man lettering. Color-coding had noeffect on the prevention of syringe-swaps in one study.Conclusions Studies performed in laboratory settings showed that Tall Man lettering contributed to a better readability ofmedication labels. Only few studies evaluated other strategies such as color-coding. More evidence, especially from real-lifesetting is needed to support safe labeling strategies.Keywords Look-alike . Label . Tall Man . Color coding . Medicatio