Medication errors are a major public health problem, particularly among the elderly. Complex treatments, polypharmacy and age-related changes increase the risks. Better prevention and appropriate support are essential to ensure that medicines are used safely and effectively.
A medication error is an unintentional error in the treatment process with medicines that causes or may cause harm to the patient.
Medication errors can have various causes and anyone involved in the treatment process is likely to make a mistake.
Examples of medication errors are the following:
- confusion between different medicines and/or incorrect intake (particularly in combination with meals);
- use of an expired medicine;
- error in storing the medicine;
- error in medical prescription;
- error in preparing the medicine;
- error in dispensing the medicine;
- error in administering the medicine (e.g. healthcare staff giving medication to the wrong person).
It is important not to confuse medication errors with medical errors.
Medication errors concern the medicine itself, whereas medical errors concern the medical act performed.
Vulnerability factors associated with ageing
- Polypharmacy: defined as taking at least five medicines, affects between 14 % and 49 % of the elderly. It increases the risk of medicine interactions and confusion between products, especially in cases of cognitive or visual impairment.
- Self-medication: this is common among the elderly, increases the risk, particularly with over-the-counter products and food supplements.
- Ageing leads to pharmacokinetic and pharmacodynamic changes: reduced renal and hepatic function, altered muscle mass and body composition. These changes influence the distribution, metabolisation and elimination of medicines. As a result, they make dosage adjustments essential and the elderly are more exposed to side effects in the event of a medication error.
Adverse drug events are almost twice as common after the age of 65, and 20 % of these events lead to hospitalisation. They are often preventable.
Prevention strategies
For healthcare professionals and caregivers
To reduce these errors, it is essential to follow the rule of the five: administer the right medicine to the right patient in the right dose by the right route at the right time.
With this in mind, several measures are recommended.
- Check the patient's identity when prescribing, dispensing and administering the medicine.
- Simplify treatment regimens where possible and be vigilant about medicine interactions and medicine cascades.
- Use available digital tools and alert systems to identify drug interactions.
- Educate patients on their treatments.
- Inform patients if a medicine is replaced or if there is a change in the presentation of a medicine that has been used for a long time.
- Suggest using a pill box.
For patients and caregivers
The following advice may be useful.
- Inform your doctor and pharmacist of all medicines and food supplements you are taking, to avoid unnecessary medicines or interactions.
- Avoid self-medication. Seek advice from a healthcare professional.
- Store the medicine as recommended in the package leaflet.
- Check the medicine's expiry date and return any expired or unused medicines to the pharmacist.
- Follow the dosage and conditions for taking medicines (known as therapeutic compliance). If necessary, use a pill box (if possible prepare it with the help of a caregiver or pharmacist).
- Caregivers are advised to check the patient's identity.
As a general rule, if you have any doubts or questions about taking medicines, ask your doctor or pharmacist for advice.
Conclusion
Preventing medication errors requires a comprehensive approach, focused on vigilance, communication and coordination, especially in the elderly. Particular attention needs to be paid to personalising treatments and supporting patients to ensure that they use medicines safely and effectively.