Chemo Medication Errors Common in Outpatient Setting

Armen Hareyan's picture
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A new study from the U.S. Agency for Healthcare Research and Quality found that 7 percent of adults and 19 percent of children taking chemotherapy drugs in outpatient clinics or at home were given the wrong dose or experienced other mistakes with their medications.

The study, to be published in the Jan. 1, 2009, issue of the Journal of Clinical Oncology, examined data on almost 1,300 patient visits at three adult oncology outpatient clinics and 117 visits at one pediatric facility between Sept. 1, 2005 and May 31, 2006.

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Fifty-five of the errors involving adults had the potential to harm, and 11 did cause harm. About 40 percent of the 22 errors in children had the potential for harm, and four children were harmed, according to Dr. Kathleen E. Walsh, the study's leader and an assistant professor of pediatrics at the University of Massachusetts School of Medicine.

Errors with adults included giving incorrect medication doses because of confusion over conflicting orders -- for example, giving one written order at the time of diagnosis and another on the day of administration. Pediatric errors included giving the wrong amount or the wrong number of doses per day for home medicines because of similarly confusing instructions.

Additionally, more than half of errors involving adults were in clinic administration, 28 percent occurred in ordering medications, and 7 percent were involved in taking drugs in patients homes. More than 70 percent of the pediatric errors occurred at home, the study found.

Walsh and her colleagues suggested that avoiding prewritten chemotherapy orders for adults in outpatient clinics may have prevented many of the errors, whereas those involving children could have been avoided by better communication and training. Specifically, the study called for more support for parents of children who use chemotherapy medications at home.

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