Are chemotherapy errors common?

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Seven 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 involving their medications, as per a newly released study led by Kathleen E. Walsh, MD, assistant professor of pediatrics at the University of Massachusetts Medical School, and reported in the January 1, 2009 issue of the Journal of Clinical Oncology
"As cancer care continues to shift from the hospital to the outpatient setting, the complexity of care is increasing, as is the potential for medicine errors, especially in the outpatient and home settings," said Dr. Walsh, who is also a Robert Wood Johnson Clinician Faculty Scholar.

An analysis of data on nearly 1,300 patient visits at three adult oncology outpatient clinics and 117 visits at one pediatric facility between September 1, 2005 and May 31, 2006 showed that errors in medicine were more common than previously reported by oncology patients.

Of the 90 medicine errors involving adults, 55 had the potential to harm the patient and 11 did cause harm. The errors included administration of incorrect medicine doses due to confusion.

over conflicting orders one written at the time of diagnosis and the other on the day of administration. Patients were also harmed by over-hydration previous to administration of medication, resulting in pulmonary edema and recurrent complaints of abdominal pain and constipation. More than 50 percent of errors involving adults were in clinic administration, 28 percent in ordering of medications, and 7 percent in use of the drugs in patients' homes.

About 40 percent of the 22 medicine errors in children had the potential to cause harm and four children were harmed. More than 70 percent of the errors in children occurred at home. Examples of pediatric errors included parents giving the wrong dose or the wrong number of doses per day of medicines because of a caregiver's confusion about instructions.

"Requiring that medicine orders be written on the day of administration, following review of lab results, appears to be a simple strategy for preventing errors among adults, while most of the errors involving children may have been avoided by better communication and support for parents of children who use chemotherapy medications at home," said Dr. Walsh.


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