February 1, 2012

Preventing Prescription Drug Errors

(Ivanhoe Newswire) -- Over 770,000 people are injured or die each year in hospitals from adverse drug events (ADEs).  Estimates say that 28 percent to 95 percent of ADEs can be prevented by reducing medication errors through computerized monitoring systems.  A recent study has found that commercial electronic prescribing systems (commonly known as e-prescribing, in which prescribers use a computer to order medications for their patients through a system with the help of prompts, aids, and alerts) could substantially reduce prescribing error rates in hospital in-patients.

The researchers studied the Cerner Millennium e-prescribing system at one ward in one hospital (Hospital A), and used three other wards as controls.  In a separate hospital they compared the error rates on two wards before and after the introduction of the e-prescribing system iSoft MedChart.  Both procedural (incomplete or unclear medication orders) and clinical (wrong dose or drug) orders were observed.  Then they were rated by severity (minor to severe).  On the three intervention wards where an e-prescribing system was implemented the procedural prescribing error rates were found to have fallen by over 90%.  Serious clinical errors declined significantly by 44% on the three wards that used the e-prescribing system compared to the serious clinical error rate that fell by 16.7% in control wards that did not get the system.  The overall rate of clinical errors (those rated as minor to serious combined) did not fall due to the fact that the e-prescribing systems introduced some new types of errors called "system-related errors,” which include selecting the wrong drug from a drop-down menu item.

“System-related errors require close attention as they are frequent, but are potentially remediable by system redesign and user training.  Importantly, the results highlight the need to continually monitor and refine the design of these systems to increase their capacity to improve both the safety and appropriateness of medication use in hospitals,” Professor Johanna Westbrook and colleagues, from the University of New South Wales in Sydney, Australia, was quoted as saying.

SOURCE:  PLoS Medicine, January 2012