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What current and missing data can teach us about medication errors
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  1. William V Padula1,
  2. Irving Steinberg2
  1. 1 Department of Pharmaceutical & Health Economics, University of Southern California School of Pharmacy, Los Angeles, California, USA
  2. 2 Department of Clinical Pharmacy, University of Southern California School of Pharmacy, Los Angeles, California, USA
  1. Correspondence to Dr William V Padula, Leonard D. Schaeffer Center for Health Policy & Economics, 635 Downey Way (VPD), University of Southern California, Los Angeles, CA, USA; padula{at}healthpolicy.usc.edu

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Medication errors have been a leading cause of preventable harm for decades. Assiri and colleagues report that the cost of medication error worldwide exceeds $42 billion, or approximately 5%–6% of all hospitalisations.1 While this topic has been closely studied since its first appearance in scientific literature in 1953,2 the problems continue to evolve alongside changes to the medication-use system. The medication-use system is a function of many elements. Widespread transitions from paper-based to electronic health records have affected drug ordering and prescribing, documentation, transcribing, dispensing, administering and monitoring in ways that challenge traditional approaches to reducing errors that predate electronic records.3 In addition, the introduction of over 7000 branded small molecules or biologics, generics and biosimilars that overlap numerous therapeutic areas increased dependence on specialty care for people with multiple chronic conditions, and navigating transitions throughout the range of primary to quaternary care have all complicated the ability of health systems to manage individual patient medication needs safely.4 Thus, solutions to address common medication errors 10 or 20 years ago may quickly become outdated in our fast-paced healthcare sector.

Medication errors can either be intercepted prior to reaching the patient or produce adverse drug events (ADEs) ranging from benign to life-threatening. Concerning prevalence rates of ADEs in hospitalised patients have been reported at 3.22% in the UK, 4.78% in Germany and 5.64% in the USA.5 For a country the size of the USA, the US Food and Drug Administration reports that this rate represents over 100 000 ADEs per year. However, these data relate only to the more severe ADEs: those resulting in death, a life threatening health state, hospitalisation, disability or birth defect.6 These figures therefore encapsulate pain and suffering as captured in administrative data but do not include the multitude of patients who missed …

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