Advertisement

International Journal of Clinical Pharmacy

, Volume 35, Issue 2, pp 185–189 | Cite as

Medication errors in a Spanish community pharmacy: nature, frequency and potential causes

  • Alina de las Mercedes Martínez SánchezEmail author
Short Research Report

Abstract

Background Medication safety has long been recognized as a key issue within the broader patient safety agenda. Errors can occur at any step along the way, from prescribing to the ultimate provision of the drug to the patient. Objective To study the nature, frequency and potential causes of medication errors in one Spanish community pharmacy. Methods A study was conducted over a 13-month period. The data included three types of written reports of incidents: prescribing errors, dispensing near-misses, and dispensing errors. Data for medication errors were collected through the internal records of the pharmacy. Results The sample consisted of 42,000 individual prescriptions, in which there were 2,117 medication errors consisting of 1,127 prescribing errors, 216 dispensing errors, and 774 dispensing near-misses. On the basis of the number of prescriptions handled during the study period, we calculated an error rate of 5.0 % (95 % confidence interval 4.8–5.2 %). The most common cause was illegible prescription (26.2 %). Conclusion This study has shown the incidence of medication errors in the health system and the possibility of detecting them in the community pharmacy. Most of the errors that occurred were reported in the prescribing stage; dispensing errors were reported less frequently.

Keywords

Community pharmacy Medication errors Patient safety Spain 

Notes

Acknowledgments

The authors wish to acknowledge Ms. Maria Cooper for her valuable assistance with the grammatical quality of this paper.

Funding

None.

Conflicts of Interest

No conflicts of interest to declare.

References

  1. 1.
    Cohen R, editor. Medication errors. 2nd ed. Washington: American Pharmacist Association; 2006 ISBN: 978-158212-092–8.Google Scholar
  2. 2.
    Parker D, Noyce P, Ashcroft D. Medication safety in community pharmacy: a qualitative study of the sociotechnical context. BMC Health Serv Res. 2009;9:158.CrossRefPubMedGoogle Scholar
  3. 3.
    Knudsen P, Søndergaard B, Rossing C. Evidensrapport 7. Kortlægning af lægemiddelrelaterede problemer. Pharmakon [Evidence report 7: Incidence of drug related problems and adverse drug events in primary care, Danish College of Pharmacy Practice]. Version 1. 2 2006. Danish.Google Scholar
  4. 4.
    Regulación de Servicios de las Oficinas de Farmacia, Ley 16/1997, 25 de Abril, de BOE número 100 (April 26, 1997).Google Scholar
  5. 5.
    Garantías y uso racional de los medicamentos y productos sanitarios. Capítulo IV. Artículo. 84, Ley 29/2006 (July 26, 2006).Google Scholar
  6. 6.
    Bosch X. New role proposed for Spanish pharmacists. Lancet. 2000;356(9223):53.CrossRefGoogle Scholar
  7. 7.
    Título de Técnico en farmacia y las Correspondientes enseñanzas mínimas, Real Decreto 547/1995 (April 7, 1995).Google Scholar
  8. 8.
    Otero M. Errores de medicación y gestión de riesgos. Rev Esp Salud Pública. 2003;77:527–40.CrossRefGoogle Scholar
  9. 9.
    Cheung K, Bouvy ML, De Smet P. Medication errors: safe dispensing. Br J Clin Pharmacol. 2009;67:676–80.CrossRefPubMedGoogle Scholar
  10. 10.
    Williams D. Medication errors. J R Coll Physicians Edinb. 2007;37:343–6.Google Scholar
  11. 11.
    Ynette K. Incidence, type and causes of dispensing errors: a review of the literature. Int J Pharm Pract. 2009;17:9–30.CrossRefGoogle Scholar
  12. 12.
    Allard J, Carthey J, Cope J. Medication errors: causes, prevention and reduction. Br J Haematol. 2002;116(2):255–65.CrossRefPubMedGoogle Scholar
  13. 13.
    Knudsen P, Herborg H, Mortensen A. Preventing medication errors in community pharmacy: frequency and seriousness of medication errors. Qual Saf Health Care. 2007;16:291–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Zavaleta-Bustos M, Castro-Pastrana LI. Prescription errors in a primary care university unit: urgency of pharmaceutical care in Mexico. Rev Bras Cienc Farm. 2008;44(1):115–25.CrossRefGoogle Scholar
  15. 15.
    Buurma H, Egberts C. Nature, frequency and determinants of pharmacy compounded medicines in Dutch community pharmacies. Br J Clin Pharmacol. 2001;52:85–91.CrossRefPubMedGoogle Scholar
  16. 16.
    Ashcroft DM, Morecroft C, Parker D. Patient safety in community pharmacy. Understanding errors and managing risk. London: Royal Pharmaceutical Society of Great Britain; 2005.Google Scholar
  17. 17.
    Chua SS, Wong ICK, Edmondson H. A feasibility study for recording of dispensing errors and “near-misses” in four UK primary care pharmacies. Drug Saf. 2003;26:803–13.CrossRefPubMedGoogle Scholar
  18. 18.
    Dean B. Learning from prescribing errors. Qual Saf Health Care. 2002;11:258–60.CrossRefPubMedGoogle Scholar
  19. 19.
    Kunac DL, Tatley MV. Detecting medication errors in the New Zealand pharmacovigilance database: a retrospective analysis. Drug Saf. 2011;34(1):59–71.CrossRefPubMedGoogle Scholar
  20. 20.
    Narinder T, Wiegmann D. The role of perception in Medication Errors: Implications for Non-Technological Interventions. Med J Arm Forces Ind. 2004;60:172–6.CrossRefGoogle Scholar
  21. 21.
    Al Khaja KA, Al-Ansari TM, Sequeira RP. An evaluation of prescribing errors in primary care in Bahrain. Int J Clin Pharmacol Ther. 2005;43(6):294–301.PubMedGoogle Scholar
  22. 22.
    Lesar T. Prescribing errors involving medication dosage forms. J Gen Intern Med. 2002;17(8):579–87.CrossRefPubMedGoogle Scholar
  23. 23.
    Bryony D, Barber N. Causes of prescribing errors in hospital inpatients: a prospective study. Lancet. 2002;359(9315):1373–8.CrossRefGoogle Scholar
  24. 24.
    Heise J. E-prescribing around the world. International Trends. Keeping in touch with developments in e-prescribing around the globe http://samedobreapteki.pl/upload/2rp_nov09_pg28.pdf. Accessed 14 Mar 2011.
  25. 25.
    Ammenwerth E, Schnell-Inderst P, Machan Ch. The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. J Am Med Informatics Assoc. 2008;15(5):585–600.CrossRefGoogle Scholar
  26. 26.
    Bergeron B. Medication errors and e-prescribing: solutions and limitations. J Med Pract Manage. 2004;20(3):152–3.PubMedGoogle Scholar
  27. 27.
    Kaushal R, Kern LM, Barrón Y. Electronic prescribing improves medication safety in community-based office practices. J Gen Intern Med. 2010;25(6):530–6.CrossRefPubMedGoogle Scholar
  28. 28.
    Fahimi F, Mohammad M, Ramin R. Transcription Errors Observed in a Teaching Hospital. Arch Iran Med. 2009;12(2):173–5.PubMedGoogle Scholar
  29. 29.
    Jiménez AB, Muiño A, Rodriguez MP. Medication error prevalence. Int J Health Care Qual Assur. 2010;23(3):328–38.CrossRefGoogle Scholar
  30. 30.
    Mrayyan M, Shishani K. Causes and reporting of medication errors in Jordan: nurses’ perspectives. J Nurs Manag. 2007; 15(6)11:659–70.Google Scholar
  31. 31.
    Bryony F, O’Grady K. Dispensing errors in community pharmacy: frequency, clinical significance and potential impact of authentication at the point of dispensing. Int J Pharm Pract. 2007;15(4):273–81.CrossRefGoogle Scholar
  32. 32.
    Bohand X, Laurent S, Perrier E. Frequency, types, and potential clinical significance of medication-dispensing errors. Clinics. 2009;64(1):11–6.CrossRefPubMedGoogle Scholar
  33. 33.
    Szeinbach S, Seoane-Vazquez E, Parekh A. Dispensing errors in community pharmacy: perceived influence of sociotechnical factors. Int J Qual Health Care. 2007;19:203–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Andrews LB, Stocking C, Kritzek T. An alternative strategy for studying adverse events in medical care. Lancet. 1997;349:309–13.CrossRefPubMedGoogle Scholar
  35. 35.
    Andersen SE, Christensen HR, Hilsted JC. Medicineringsproblemer og risikostyring [Medication problems and risk management]. Ugeskr Læger 2001; 163:5361–4.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  1. 1.Universidad Internacional de La RiojaMadridSpain

Personalised recommendations