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Rate of serious at-home medication errors has risen dramatically, study reports

REUTERS/Gary Cameron
Serious medication errors jumped 100 percent during the 13-year period of the study, from 1.09 per 100,000 residents in 2000 to 2.28 in 2012.

Every 21 seconds, someone in the United States calls a poison control center about a medication error, a rate that has increased 100 percent since 2000, according to a national study published Monday. 

These are errors that occur outside of hospitals, usually in the home. Most involve taking either the wrong dose or the wrong medication — or inadvertently taking a medication twice.

The medications that most commonly result in serious health problems, the study found, are drugs used to treat heart disease (especially beta blockers and calcium channel blockers),  drugs used to reduce pain (especially prescription opioids and acetaminophen), drugs used to treat diabetes (especially insulin and sulfonylureas) and drugs used to treat depression, anxiety and other mental illnesses (especially atypical antipsychotics).

About a third of the medication errors result in people being hospitalized. And in a small percentage of the cases, the errors lead to deaths. Drugs used to treat heart disease and to reduce pain account for more than two-thirds of those deaths.

Such tragic outcomes are almost always preventable, but the ways in which medications are prescribed and packaged often leads to consumer confusion, the study points out. 

“Drug manufacturers and pharmacists have a role to play when it comes to reducing medical errors,” said Henry Spiller, one of the study’s authors and director of the Central Ohio Poison Center at Nationwide Children’s Hospital in Columbus, Ohio, in a released statement. “There is room for improvement in product packaging and labeling. Dosing instructions could be made clearer, especially for patients and caregivers with limited literacy or numeracy.”

Key findings

For the study, Spiller and his colleagues analyzed national data reported to U.S. Poison Control Centers from 2000 to 2012. Previous research on medication errors had focused mainly on mistakes within hospitals. Spiller’s team wanted to examine the rate of errors that occur outside of health care facilities.

Here are some of their key findings:  

  • Serious medication errors jumped 100 percent during the 13-year period of the study, from 1.09 per 100,000 residents in 2000 to 2.28 in 2012. The error rate rose steadily during those years among people aged 6 or older. But in children under the age of 6, the rate increased only to 2005, after which it gradually decreased. The researchers attribute that decrease to warnings from health officials about giving over-the-counter cough and cold medicines to young children.
  • The study found there were 67,603 serious medical errors during the study period — an average of 5,200 a year. Most — 93.5 percent — had a moderate effect on the patient’s health. But 5.8 percent has a major effect, and 0.6 percent (414) resulted in death.
  • The rate of serious medication errors linked to drugs used to treat heart disease rose 177 percent between 2000 and 2012 — probably because more Americans are being treated for various cardiovascular disorders, say the researchers. About 20 percent of serious medication errors identified in the study involved these drugs — almost twice as many as any other drug category. And more than half of those errors resulted in hospitalization.
  • The second-highest number of hospitalizations resulting from medication errors involved analgesics, or painkillers. One-third of medication errors in this category involved opioids — not surprising, given the growing prescription opioid epidemic in the U.S. But even more of the errors — 44 percent — were attributed to acetaminophen, used either alone (as an over-the-counter drug) or in combination with other prescription drugs.
  • Serious medication errors related to drugs used to treat diabetes increased 345 percent during the study period — mostly likely because of the surging numbers of Americans being diagnosed with type 2 diabetes, the researchers note.  
  • Most serious medication errors among children younger than 6 involved cold and cough preparations (19.2 percent) gastrointestinal preparations (11.8 percent) and heart-disease drugs (11.1 percent).

A preventable problem

“Managing medications is an important skill for everyone, but parents and caregivers have the additional responsibility of managing others’ medications,” said Nichole Hodges, a study co-author and a research scientist at the Center for Injury Research and Policy at Nationwide Children’s, in the released statement. “When a child needs medication, one of the best things to do is keep a written log of the day and time each medication is given to ensure the child stays on schedule and does not get extra doses.”

Here are other tips for preventing medication errors from Hodges and her colleagues:

  • Write it down. Parents and caregivers can write down what time medications are given to prevent another caregiver from unintentially give the medication a second time. This is even helpful for adults taking more medication than usual.
  • Ask questions. Physicians and pharmacists can teach patients, parents, and caregivers how to take or give medications to minimize the likelihood of medication errors. Parents and patients can ask questions until they fully understand how and when to take medications. If a question arises at home, call your pharmacist or physician.
  • Use child-resistant packaging. While most medications enter the home in child-resistant packaging, people who take multiple medications often repackage them into weekly pill planners. If you are going to use a pill planner, use a child-resistant one and store it up, away, and out of sight.

FMI:  The study was published in the journal Clinical Toxicology, where it can be read in full.

Comments (1)

  1. Submitted by Connie Sullivan on 07/11/2017 - 03:12 pm.

    How many of the instances of mistakes made at home were made by people over the age of 65? Curiously, these are the Americans who take most medications.

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