Abstract

ASSESSMENT OF MEDICATION ERRORS IN CHEMOTHERAPY RECEIVING PATIENTS IN TERTIARY CARE HOSPITAL

Venkatrajan Rangaraju*, Aashiq Ahamed shukkoor, Mathipriya Ponnuvel, Sivakumar Velusamy

ABSTRACT

Objective: Identifying, Analyzing and developing prevention strategies for medication errors in cancer patients receiving chemotherapy. Methods: A prospective, open labeled, Observational study was conducted in the Department of Medical Oncology, in a tertiary care hospital in Tamil Nadu, India. Patients who came to receive chemotherapy during the period of 6 months from Jan 2016 to June 2016 were included in the study. Medication history interview, reconstitution procedures, administration procedures and chemotherapy chart review were done. Drugs administered for other co morbid conditions were not been considered for assessing medication errors. Medication errors were assessed based on the NCCMERP index and statistical analysis was done by using SPSS tool. Prevention strategies were developed to rectify the medication errors and factors which influence the medication error. Result: Medication Error among the patients receiving chemotherapy was identified to be 51.08%, of which, prescribing error was 19.79%, administration error was 27.08%, wrong dose was 41.66%, wrong drug error was 3.12% and wrong strength was 8.33%. Based on the NCCMERP index, the majority of errors (70%) fell in the category Error, No Harm, followed by which 34% belongs to no error and 2% with Error, Harm and there was no death occurred due to medication error. Further, the errors were grouped into 8 categories (Category A to Category I). The majority of errors (35%) fall into category A. Among various chemotherapeutic agent, 5-Fluorouracil was found to have more medication error (34.32%). Chemotherapeutic drugs found to have more medication error (79%) compared to adjuvant drugs (21%) used for the patient preparation for chemotherapy. We analysed the factors influencing the medication errors as, patient factors, disease factors, working environmental factors, drug factors, lack of interdepartmental activity, reconstituition factors. Descriptive analysis was performed to estimate number of medication errors and expressed as total number of errors and percentage. Prevention strategy was developed for the identified factors which influence the medication errors. Conclusion: Developing unique drug guidelines that address the institutions dose information, making drug info available electronically and train all members of the team to use electronic drug information can reduce medication error. In chemotherapy, the total no. of drugs given to the patient cannot be reduced so, there will be error occurance at some point, which is unavoidable.

Keywords: Chemotherapy, NCCMERP Scale, Medication Errors, Cancer.