A cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in KPK, Pakistan

Abstract Background Medication safety in cancer patients receiving complex medication regimens is an important problem in various settings. Medication related events, interceptions and interventions are not well described in this area. We intended to study incidence, types, settings and stages invol...

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Main Authors: Marium Azim, Ahmad Khan, Tahir Mehmood Khan, Mohammad Kamran
Format: Article
Language:English
Published: BMC 2019-08-01
Series:BMC Health Services Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12913-019-4420-7
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spelling doaj-32da386597ae4729aed7c5f84194ab1c2020-11-25T03:42:32ZengBMCBMC Health Services Research1472-69632019-08-0119111210.1186/s12913-019-4420-7A cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in KPK, PakistanMarium Azim0Ahmad Khan1Tahir Mehmood Khan2Mohammad Kamran3Quaid-I-Azam University, QAU IslamabadDepartment of Pharmacy, Qauid-I-Azam University, QAU IslamabadInstitute of Pharmaceutical Science, UVAS LahoreRiphah International University IslamabadAbstract Background Medication safety in cancer patients receiving complex medication regimens is an important problem in various settings. Medication related events, interceptions and interventions are not well described in this area. We intended to study incidence, types, settings and stages involved, root cause analysis, medication classes involved and the level of harm cause by medication errors in two hospitals providing oncology services comparatively. The severity of incidents and interventions are studied. Methods It was a prospective cross sectional study among cancer in-patients of two tertiary care hospitals of KPK. Scale by NCC-MERP was used for evaluation of all medication related incidents. The data obtained was analyzed by IBM SPSS statistics 22 with 95% confidence interval and used the same for other descriptive statistics. Results All medication orders were reviewed at both sites (Computerized Prescription Order Entry and HWP systems). Potential ADEs incidence was found high at site 2 (97.5%) while medication errors without harm was high at site 1 (97.5%). Most events occur at prescribing level 87.6 and 81.7% at both sites 1 and 2. Types highly reported involved improper dose 31.4 and 15.5%, monitoring error 14.6 and 15.2% at site 1 and 2. Medications involved in these incidents were antibiotics 44 and 12.7%, antiemetic 7.5 and 15.8% and antineoplastic 2.9 and 9.4% at site 1 and 2. Severity of 3.6 and 36.5% incidents had potential to cause harm at site 1 and 2. Root causes were human factors 62.6 and 72.3%, drug selection 33.6 and 38.8%, and dose selection 39.6 and 15.3% at sites 1 and 2. Contributing factors including staff training 33.6 and 24.3%, system for covering patient care 14.9 and 36.6%, communication system 2.4 and 20.3%, interruptions 9.7 and 7.3% and others 78.8 and 68.6% were highly reported. Preventability of medication errors was 99% at both sites. Intervention was taken in 90.5% events at site 1 (CPOE system) while the incidence lowest at site 2 (HWP system). Conclusion Medication related events are high among cancer in-patients at the site lacking updated electronic system for medication prescribing. Proper training about medication safety, reporting and interventions are required.http://link.springer.com/article/10.1186/s12913-019-4420-7Medication safetyMedication related eventsInterventionsRoot cause analysisContributing factorsChemotherapy
collection DOAJ
language English
format Article
sources DOAJ
author Marium Azim
Ahmad Khan
Tahir Mehmood Khan
Mohammad Kamran
spellingShingle Marium Azim
Ahmad Khan
Tahir Mehmood Khan
Mohammad Kamran
A cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in KPK, Pakistan
BMC Health Services Research
Medication safety
Medication related events
Interventions
Root cause analysis
Contributing factors
Chemotherapy
author_facet Marium Azim
Ahmad Khan
Tahir Mehmood Khan
Mohammad Kamran
author_sort Marium Azim
title A cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in KPK, Pakistan
title_short A cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in KPK, Pakistan
title_full A cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in KPK, Pakistan
title_fullStr A cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in KPK, Pakistan
title_full_unstemmed A cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in KPK, Pakistan
title_sort cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in kpk, pakistan
publisher BMC
series BMC Health Services Research
issn 1472-6963
publishDate 2019-08-01
description Abstract Background Medication safety in cancer patients receiving complex medication regimens is an important problem in various settings. Medication related events, interceptions and interventions are not well described in this area. We intended to study incidence, types, settings and stages involved, root cause analysis, medication classes involved and the level of harm cause by medication errors in two hospitals providing oncology services comparatively. The severity of incidents and interventions are studied. Methods It was a prospective cross sectional study among cancer in-patients of two tertiary care hospitals of KPK. Scale by NCC-MERP was used for evaluation of all medication related incidents. The data obtained was analyzed by IBM SPSS statistics 22 with 95% confidence interval and used the same for other descriptive statistics. Results All medication orders were reviewed at both sites (Computerized Prescription Order Entry and HWP systems). Potential ADEs incidence was found high at site 2 (97.5%) while medication errors without harm was high at site 1 (97.5%). Most events occur at prescribing level 87.6 and 81.7% at both sites 1 and 2. Types highly reported involved improper dose 31.4 and 15.5%, monitoring error 14.6 and 15.2% at site 1 and 2. Medications involved in these incidents were antibiotics 44 and 12.7%, antiemetic 7.5 and 15.8% and antineoplastic 2.9 and 9.4% at site 1 and 2. Severity of 3.6 and 36.5% incidents had potential to cause harm at site 1 and 2. Root causes were human factors 62.6 and 72.3%, drug selection 33.6 and 38.8%, and dose selection 39.6 and 15.3% at sites 1 and 2. Contributing factors including staff training 33.6 and 24.3%, system for covering patient care 14.9 and 36.6%, communication system 2.4 and 20.3%, interruptions 9.7 and 7.3% and others 78.8 and 68.6% were highly reported. Preventability of medication errors was 99% at both sites. Intervention was taken in 90.5% events at site 1 (CPOE system) while the incidence lowest at site 2 (HWP system). Conclusion Medication related events are high among cancer in-patients at the site lacking updated electronic system for medication prescribing. Proper training about medication safety, reporting and interventions are required.
topic Medication safety
Medication related events
Interventions
Root cause analysis
Contributing factors
Chemotherapy
url http://link.springer.com/article/10.1186/s12913-019-4420-7
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