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Drug Safety: 93 patients and 149 errors suggests a rethink

Drugs are perfectly safe – while they remain in their containers.  But things go terribly wrong, and in the vast majority of cases, once they’ve been prescribed, as a new study has discovered.

Researchers tracked the progress of 93 patients following a liver or kidney transplant who were each given an average of 10 different drugs as part of their out-patient care.

In all, the researchers identified 149 errors, including adverse reactions that saw 17 of the 93 patients back in hospital.  Another three needed special out-patient treatment.

Twenty of the prescriptions were wrongly prepared, and another 20 specified the wrong dose.  Even if the doctors didn’t get it wrong, someone else down the line did.  Pharmacy staff and others in the chain were responsible for a further 41 errors.

As we say, keep ‘em in the containers.

(Source: Archives of Surgery, 2007; 142: 278-83).


E-news broadcast 31 May 2007 No.364
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