Comparative study on medication errors between elderly and non-elderly patients in China based on data from monitoring network of clinical medication safety

Abstract

Objective To know the situation of ME in the present and explore the characteristics of ME between the elderly and non-elderly patients in China. Methods ME reports from September 22, 2012 to June 30, 2015 in the Monitoring Network of Medication Safety in China Core Group of International Network for the Rational Use of Drugs (INRUD) were taken. The patients with age 65 years were entered into the elderly patient group and other patients were entered into the non-elderly patient group. The ME category, the persons that triggered ME, ME content, and drugs related to ME in the 2 groups were analyzed and compared. Results Within A total of 8 421 cases of ME were reported and involved 8 421 patients. Of them, 2 503 patients (29.72%) were in the elderly patient group and 5 918 (70.28%) in the non-elderly patient group. The most errors [98.41%(8 287/8 421)] belonged to the second level of ME which did not induce injury to patients. The difference of distribution of ME with different categories between the elderly and non-elderly patient groups were not statistically significant (P>0.05). The errors that triggered by doctors and pharmacists were 5 599 cases (66.49%) and 2 567 cases (30.48%), respectively. The errors that triggered by doctors in the elderly patient group were higher than those in the non-elderly patient group [69.64%(1 743/2 503) vs. 65.16%(3 856/5 918)], the errors that triggered by pharmacists in the elderly patient group was lower than those in the non-elderly patient group [27.21%(681/2 503) vs. 31.87%(1 886/5 918)], and the differences between the 2 groups were statistically significant (all P<0.05). The top 5 errors that triggered by doctors were drug dosage [27.56%(1 543/5 599)], administration frequency [12.40%(694/5 599)], indication [9.09%(509/5 599)], route of administration [8.64%(484/5 599)], and solvent [7.89%(442/5 599)]. The errors about administration frequency, contraindication, and interaction in the elderly patient group were higher than those in the non-elderly patient group (all P<0.05). The top 5 errors that triggered by pharmacists were variety of drugs [51.69%(1 327/2 567)], number of drugs [14.57%(374/2 567)], specification [12.23%(314/2 567)], others [6.31%(162/2 567)], and dosage form [4.25%(109/2 567)]. The errors about number of drugs, administration time, administration frequency, and solvent in the elderly patient group were higher than those in the non-elderly patient group (all P<0.05). There were 6 742 drugs involved in ME, the top 5 drugs were anti-infective agents (1 309 cases, 19.42%), cardiovascular drugs (848 cases, 12.58%), digestive system drugs (649 cases, 9.63%), nervous system drugs (584 cases, 8.66%), and respiratory system drugs (543 cases, 8.05%). The proportions of respiratory system drugs, urinary and reproductive system drugs, allergy and immune system drugs, biological products/vaccines, rheumatoid arthritis and arthritis drugs, and ear/mouth/throat drugs used in the elderly patient group were higher than those in the non-elderly patient group (all P<0.05). Conclusion The most MEs in China belong to the second level which occurred but did not cause injury to the patients, doctors and pharmacists are key personnel that trigger the ME. The doctors or pharmacists that trigger the ME, ME contents, the composition of drugs related to ME are different between the elderly patients and the non-elderly patients. Doctors should pay more attention to frequency of administration, contraindication, and interaction of drugs during prescribing for elderly patients, pharmacists should pay more attention to the number of drugs, administration time, frequency of administration, and solvent during allocating drugs for elderly patients. Key words: Aged; Medication errors; Drug monitoring