A recent study by the University of Finland in Kuopio indicates that the elderly are increasingly being subjected to dangerous preventable medication errors. This is a particularly difficult problem as they tend to have more chronic conditions and are among the most vulnerable. Much of the report attributes the problem to negligence among physicians. Marja Harkanen, Ph.D., used data from over 500,000 patients between 2007 and 2016 and found roughly 229 such incidents. Those 75 years of age or older were the victims approximately 41% of the time.
Medications Commonly Involved
The classes of drugs most commonly cited were cardiovascular, antibiotics and those for treatment of the central nervous system. Anticoagulants commonly called “blood thinners” are among the most deadly. Roughly 31 percent of the errors involved were the result of an accidental omission of a particular drug. Physicians also seemed to have many errors involving patients younger than 12. In these cases, often the problem is associated with drugs prescribed to treat infections. The report cited medication administration errors (MAEs) as the term used to describe the majority of mistakes.
- Nelson Tyler, an 83-year-old patient in Missouri, was inadvertently administered a lethal dose of fentanyl. He was given 125 milligrams of the medication, which is known to be considerably stronger than morphine. He soon went into cardiac arrest and was pronounced dead several days later.
- At Vanderbilt University Medical Center in Tennessee, a nurse mistakenly injected a patient with a drug used exclusively for lethal injections of inmates on death row. The nurse was supposed to be providing an anti-anxiety medication.
Understanding Risk of Multi-Morbidity
Older patients are more likely to be considered “multi-morbid,” which means that they have multiple health conditions. The problem here is these patients are likely to be prescribed various volatile types of medication. This increases the chance for mistakes including adverse interactions among the medications. Many of these geriatric patients are believed to be “over-prescribed” medications and are less likely to be aware of the drugs they are taking.
There is no single solution to prevent all these types of errors. The way to reduce these mishaps is believed to be a combination of improved education, better communication, and employment of advanced technology. Often the problem involves communication between the doctors who are prescribing and those in the pharmacy. Advancements to electronic prescribing have led to better screening tools that are designed to “catch” potential problems. In some cases, medication errors are also attributed to insufficient staffing levels at medical facilities.
Understanding Medication Errors
It is important to make the distinction between medication errors and errors that occur during the process of administration or dispensing of medications. A medication error is simply defined as being “a failure in the treatment process” that causes harm. Marja Harkanen explained the key to prevention in a summary as follows:
- The patient receives the correct medication
- The proper dosage of the medication is given
- Medication is provided at the right time (time of day, frequency, etc.)
- Medication is administered in the correct way (orally, via injection, etc.)