By David Bui
A new study in the Canadian Pharmacists Journal, looking at patient-related risk factors for medication errors, found that older women taking multiple medications are at greater risk than men for self-reported medication errors—errors reported by the patient.
Women were found to be 1.2 times more likely than men to experience a medication error. Furthermore, individuals 50-64 years old were nearly 1.5 times more likely than patients 18-24 to experience a medication error while those 65 years an older were nearly 1.8 times more likely.
“Prior studies that looked at the risk for inappropriate medication prescribing in elderly care also found women to be two times more likely than men to experience a medication error,” said Dr. Kim Sears, lead author on the paper. “I think the issue may be that women are living longer than men and they often have complex needs [and] are ordered more medications.”
The study also reported that the number of medications prescribed to a patient was significantly associated with the occurrence of an error. Patients taking 6-10 prescriptions were 1.6 times more likely to experience a medication error than patients taking 1-5. For those taking more than 10 prescriptions—the risk of error was 2.5 times higher. “Every time you increase the medication you increase the risk [for error],”said Sears. “You run into more risks for adverse drug interactions.”
The study also reviewed the difference in risk for community versus hospital settings and found that about 4 of every 5 errors reported occurred in a community setting. In fact—nearly every factor they considered was associated with higher risks for errors in community settings than in hospitals.
“Communications between providers in a community setting is a big factor in adverse [medication] outcomes. Hospitals already face challenges in communicating among in-house team members, but when you go out into the community setting—there are so many community providers involved in patient care and no central or national reporting system,” said Sears. “Patients may be seeing different providers and [the patients] aren’t always sure of what they’re taking.”
To compound the challenges, community providers are also treating increasingly more specialized conditions, and the need to communicate between providers is even more urgent. “The healthcare system is more complex than ever before,” said Sears. “You have patients going to community providers for things that would have been inpatient problems in the past.”
While increasing error reporting and communications between providers may help catch and rectify medication errors, there is little incentive for community providers to do so. In fact, even if there were a voluntary national reporting system, reporting errors would likely remain quite low.
While these communication gaps may exists between providers, Dr. Sears suggests that there are things patients can do to minimize those risks, like building relationships with their community providers and going to the same pharmacy to build a medication history. “One simple thing that patients could do is to keep a sheet or record of their medication history. Having a list of current medications they’re on, the reasons for taking them, and even medications they were taken off of and why.”
Medication errors are a persistent concern in all healthcare settings given their negative impact on population health as well as the financial burden they entail. One study has estimated that about 28% of all emergency room visits were drug related and more importantly—70% were preventable. In dollars and cents, $3.5 billion annually has been attributed to medication errors in the United States and up to C$11 billion in Canada.