MEDICATION ERRORS: AN AVOIDABLE BURDEN TO HEALTHCARE

MEDICATION ERRORS: AN AVOIDABLE BURDEN TO HEALTHCARE

The main objective of most of the developing countries in the world is the provision of quality, safe, reliable and accessible healthcare. The healthcare system is well equipped with an increased volume of variety of medicines because of increasing number of more and more complex diseases which in turn result in increased number of medicines prescribed per patient. In developing countries like India, some of the healthcare consumers have become more conscious of their health needs and demand evidence-based healthcare system and the other side comprises of illiterate people and is unaware of their health needs and they don’t think about the chances of mishappenings in the care process.The healthcare system is susceptible to errors in delivering services because it is a human industry. So there is an urgent need to have the monitoring of healthcare services for the holes and drops in the process of care. The Institute Of Medicine report says that the medication errors as the 8^th leading cause of death in US. There is only a small number of medication error studies from India compared to the developed countries which are having advanced and well developed quality healthcare system. From these, we can guess that the Indian scenario of medication errors might be worse than this.

The FDA new drug approvals are increased nowadays resulting in increased cost of care and complexity of managing their use. This necessitates the development and maintenance of safe medication practice to ensure the best healthcare delivery to the patients.

Some tragic medication errors have occurred in recent years          

Ø     A chemo therapy mix up at a major cancer centre resulted in the death of patient from a fourfold overdose daily for four days.

Ø     A child accidentally received an IV dose rather than IM dose of long acting Penicillin and died.

Ø     A compounding error resulted in death of a child who received a tri-cyclic anti depressant at a dose ten times greater than the dose prescribed by the physician.

Ø     Mix ups with Heparin vials which had similar packaging, but different concentrations, resulted in over doses causing serious injury and several infant death.

Addressing medication errors in Indian scenario

·         The hospitals should have quality assurance system to develop and establish policies and procedures on managing medication errors and to ensure that they are strictly followed at each level of medication use process.

·         Most of the medication errors go unreported, so that investigation and prevention strategies cannot be developed. It may be due to fear of disciplinary action and to improve this situation, develop a culture so that staff feels free to report the errors via incident reporting.

·         The effective establishment of hospital formulary.

·         Improve the handwriting of physicians and write dosages and instructions carefully and clearly in block letters.

·         Develop a pediatric formulary system which includes specific policies for evaluating, selecting and using medications.

·         Prescribers should include dosage calculations on all orders and prescriptions except for otic, topical and ophthalmic products.

·         The patients should be well informed about their diagnoses, treatment plan, drugs prescribed with their indications, how many times they should get their medicines, in what doses, importance of reporting any reactions and the need of patient compliance to the prescribed regimen.

·         Continuing education should be provided for each staff and they should be well trained in handling medications.

·         Improve handing over and communication among health professionals.

·         Provide sufficient staff for performing duties.

·         Should provide facilities for compounding the medicines especially for pediatric patients with well qualified and trained pharmacy staff.

·         Provide facilities for double check for dispensing and administration procedures.

·         Ensure that each patient get their right medicine in right quantity at right time.

·         Include well qualified and trained clinical pharmacist in the patient care team for the reduction of medication errors to a large extent.

·         Adoption of Computerized Physician Order Entry, automated dispensing systems, and barcode system may increase the cost of healthcare, but sometimes it may be more economic than increased incidence of medication errors and their follow up.

“Quality use of medicines will increase quality without reducing quantity of life”   

Shamna M

Asst prof

Alshifa college of pharmacy