Monitoring for medication errors in outpatient settings

Abstract

Background: Vigilant reporting of medication errors and adverse drug events (ADEs) is needed to understand and reduce the extent of this problem in dermatology. Various systems are already in place in inpatient settings. Objective: To review existing medication error reporting systems related to outpatient settings with emphasis on topical medications associated with dermatological diseases. Method: Search terms ‘medication error’, ‘outpatient settings’, ‘barriers’, ‘medication use process’, ‘CPOE’ (computerized prescriber order entry), ‘dermatological conditions’ and ‘skin disorders’ were used. Results: The rate of medication-related incidents range as high as 4.49 per 1000 to 24.1 per 1000 inpatient days. The most common error type was patient error, accounting for 56% of errors. Other errors that occurred were prescription errors (13%), delivery errors (13%), availability errors (10%), and reporting errors (8%). CPOE systems can increase medication safety, while introducing other problems including faulty computer interface, miscommunication with other systems, lack of adequate decision support, and other human errors (knowledge deficit, distractions, inexperience, and typing errors). Conclusion: There is an opportunity for improved tracking and reporting of medication errors in dermatology. Systems are needed to ensure that patients understand how their medication should be used.