Medication errors in the homes of children with chronic conditions
Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine; Department of Pediatrics
Adolescent; Anemia, Sickle Cell; Child; Child, Preschool; Chronic Disease; Communication; Drug Labeling; Drug Storage; Educational Status; Female; Home Nursing; Humans; Infant; Male; Medication Errors; Prospective Studies; Seizures; Young Adult
Health Services Research | Pediatrics | Primary Care
BACKGROUND: Children with chronic conditions often have complex medication regimens, usually administered at home by their parents.
OBJECTIVE: To describe the types of medication errors in the homes of children with chronic conditions.
METHODS: Our home visit methods include direct observation of administration, medication review and prescription dose checking. Parents of children with sickle cell disease and seizure disorders taking daily medications were recruited from paediatric subspecialty clinics from November 2007 to April 2009. Potential errors were reviewed by two physicians who made judgments about whether an error had occurred or not, and its severity.
RESULTS: On 52 home visits, the authors reviewed 280 medications and found 61 medication errors (95% CI 46 to 123), including 31 with a potential to injure the child and 9 which did injure the child. Injuries often occurred when parents failed to fill prescriptions or to change doses due to communication problems, leading to further testing or continued pain, inflammation, seizures, vitamin deficiencies or other injuries. Errors not previously reported in the literature included communication failures between two parents at home leading to administration errors and difficulty preparing the medication for administration. 95% of parents not using support tools (eg, alarms, reminders) for medication use at home had an error compared to 44% of those using supports (chi(2)=13.9, p=0.0002).
CONCLUSIONS: Home visits detected previously undescribed types of outpatient errors which were common among children with sickle cell disease and seizure disorders. These should be targeted in future intervention development.
DOI of Published Version
Arch Dis Child. 2011 Jun;96(6):581-6. Epub 2011 Mar 27. Link to article on publisher's site
Archives of disease in childhood
Walsh, Kathleen E.; Mazor, Kathleen M.; Stille, Christopher J.; Torres, Irma; Wagner, Joann L.; Moretti, Juliet; Chysna, Kevin; Stine, Christy D.; Usmani, G. Naheed; and Gurwitz, Jerry H., "Medication errors in the homes of children with chronic conditions" (2011). Meyers Primary Care Institute Publications and Presentations. 508.