Medication Errors Often Seen in Chemotherapy TreatmentJan 2, 2009 | Parker Waichman LLP Medication errors are more common that previously believed in chemotherapy treatment. It seems about seven percent of adults and 19 percent of children receiving outpatient chemotherapy treatment—in clinics or at home—have been subjected to incorrect dosing or other medication mistakes, according to a new study by the University of Massachusetts Medical School, reports Science Daily. The team looked at the records of nearly 11,000 drugs taken by cancer patients at three adult and one pediatric oncology clinics said White Coat Notes, which added that an earlier study that only looked at medications given at a cancer center revealed a three percent error rate.
Study lead Kathleen E. Walsh, MD, assistant professor of pediatrics at the University of Massachusetts Medical School and a Robert Wood Johnson Physician Faculty Scholar, said, "As cancer care continues to shift from the hospital to the outpatient setting, the complexity of care is increasing, as is the potential for medication errors, particularly in the outpatient and home settings," quoted Science Daily. Science Daily also noted that data analysis on about 1,300 adult patient visits and 117 pediatric visits from September 1, 2005 and May 31, 2006 revealed medication errors were more common than previously reported.
Of 90 medication errors—such as incorrect dosing due to confusion, conflicting orders, and overhydration—involving adults, 55 could have potentially harmed the patient, while 11 caused harm, said Science Daily. Over half of the errors to adults involved clinical administration; 28 percent, the ordering of drugs; and seven percent, use of medication in patients homes, said Science Daily, adding that 40 percent of 22 errors in children harmed four and could have potentially harmed the rest. Some errors in pediatric dosing occurred over wrong medication amounts or frequency, reported WebMD. Errors in adult dosing occurred, WebMD added, over confusion over conflicting orders, overhydration prior to treatment, and abdominal pain because treatment for constipation did not occur prior to treatment, for example.
"As cancer care shifts from the hospital to the outpatient setting, adults and children with cancer receive more complicated, potentially toxic medication regiments in the clinic and home," the team wrote, said WebMD. The study was published in the Journal of Clinical Onclology, said WebMD, which pointed out that the journal described the errors as “high” in both adult and pediatric cancer patients.
The team concluded, reports the Washington Post, that treatment orders should be written on the day of treatment and pediatric care include improved communication and training as well as heightened parental support. "Requiring that medication orders be written on the day of administration, following review of lab results, may be a simple strategy for preventing errors among adults, while most of the errors involving children may have been avoided by better communication and support for parents of children who use chemotherapy medications at home," said Dr. Walsh, quoted Science Daily.
White Coat Notes said that most errors involved dosing errors usually resulting from duplicate orders—one written at diagnosis and one at treatment. Only five such errors were caught before treatment said White Coat Notes. WebMD pointed out that the researchers indicated that prevention of such outpatient medical errors fails because of a variety of issues such as “a lack of recognition of errors, communication problems, and fragmentation of care."