Study finds high medication error rates among adults and children receiving outpatient cancer treatment
Research Activities, August 2009, No. 348
A growing number of cancer patients are now able to receive treatment in the outpatient setting, including clinics, doctors' offices, and even at home. However, medication error rates are high in both adults and children receiving outpatient chemotherapy for cancer, reveals a new study. Researchers from the HMO Research Network Center for Education and Research on Therapeutics (CERT) reviewed the medical records of patients receiving treatment from one pediatric and three adult oncology clinics. The researchers reviewed 1,262 adult patient visits involving 10,995 medications and 117 pediatric visits involving 913 medications.
The researchers identified 112 medication errors, for an overall rate of 8.1 errors per 100 clinic visits. More than half of chemotherapy errors (57.1 percent) had the potential to cause patient injury. Only 4 percent of errors were stopped before they reached the patient. Most errors involved medication administration (56 percent) and prescribing (36 percent). Administration errors were often due to confusion over two sets of orders, one written at diagnosis and another adjusted dose on the day of administration. This problem could be reduced by improved communication, note the researchers. In adults, the medication error rate was 7.1 errors per 100 visits. Drugs most commonly associated with errors were zoledronic acid and leuprolide. The majority of errors took place during clinic administration (56 percent); only 7 percent involved home administration.
The medication error rate was much higher in children: 18.8 errors per 100 visits. Medications most susceptible to errors were dapsone and cyproheptadine. Errors took place most often in ordering (64 percent) and home administration (27 percent). However, more than half of the pediatric errors that had the potential for patient harm occurred when giving medications in the home.
The study was funded in part by a grant from the Agency for Healthcare Research and Quality (HS10391) to the HMO CERT. For more information on the CERT program, please visit http://certs.hhs.gov/.
See "Medication errors among adults and children with cancer in the outpatient setting," by Kathleen E. Walsh, M.D., M.Sc., Katherine S. Dodd, Ph.D., R.N., Kala Seetharaman, M.D., and others in the February 2009 Journal of Clinical Oncology 27(6), pp. 891-896.