Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New Research Shows Deadly Drug Mistakes Spike At The Start Of Each Month, Suggests Pharmacy Errors

06.01.2005


Beware not the ides but the start of March – and April and May and every month. In the first few days of each month, fatalities due to medication errors rise by as much as 25 percent above normal, according to new research by University of California, San Diego sociologist David Phillips.


Total numbers of U.S. deaths related to medication errors (± 1.96 standard errors) on each of the first 14 days of the month (days 1 to 14) and the last 14 days of the preceding month (days -14 to -1), 1979-2000. The panel shows data for patients who were dead on arrival and for those who died in the emergency room and as outpatients. The horizontal solid line shows total numbers of deaths from all causes. The dotted line indicates the average number of deaths that would be expected if the numbers did not fluctuate around the first day of the month. The bar graph indicates the total number of deaths from fatal medication errors. The upper limit is set at 1.40 x daily average, whereas the lower limit is set at 0.85 x daily average.



Published in the January issue of Pharmacotherapy, the journal of the American College of Clinical Pharmacy, the study is the first to document a beginning-of-the-month spike in deaths attributed to mistakes in prescription drugs.

The primary suspect, Phillips says, is a beginning-of-the-month increase in pharmacy workloads and a consequent increase in their error rates. “Government assistance payments to the old, the sick and the poor are typically received at the beginning of each month. Because of this, there is a beginning-of-the-month spike in purchases of prescription medicines,” Phillips says. “Pharmacy workloads go up and – in line with both evidence and experience – error rates go up as well. Our data suggest that the mortality spike occurs at least partly because of this phenomenon.”


Phillips and his coauthors examined all United States death certificates from 1979 through 2000 to analyze the 131,952 deaths classified as fatal poisoning accidents from drugs. A small number, 3.2 percent, of the deaths were from adverse effects of the right drug in the right dose. The vast majority, 96.8 percent, resulted from medication errors – the “wrong drug given or taken,” or “accidental overdose of drug,” or “drug taken inadvertently.”

The study excluded deaths from overdose of street drugs or from intentional poisoning (suicide or homicide).

The beginning-of-the-month mortality spike was particularly pronounced in people for whom the mistakes proved rapidly fatal – those who were dead on arrival at a hospital, died in the emergency department or as outpatients. In this category, deaths jumped by 25 percent above normal.

But could it be that the mortality spike is due not to pharmacy error but simply to the increased number of people buying, then consuming drugs?

To test this, Phillips and coauthors ran analyses on populations of the elderly and the poor. If increased consumption alone was to blame, the researchers reasoned, mortality would be highest in the groups relying on government assistance and therefore purchasing their medicines at the start of the month.

The beginning-of-the-month spike was similar across groups, however. The spike was as evident in the young and well-off as in the elderly and poor, suggesting the problem was at least partly due to an increase in pharmacy error at the beginning of the month.

Phillips notes that the National Center for Health Statistics database used in the study did not contain highly specific clinical information – no information on prescription type, dosage, days supply, etc. – and he urges further research with data richer in this kind of detail.

To reduce the medication-error death rate, Phillips suggests that pharmacies (that don’t already do so) consider increasing staffing levels at the beginning of the month and that government officials consider spreading assistance payments out over the entire month.

“Even in the absence of policy changes or further research,” Phillips says, “it is appropriate for both patients and clinical staff to be especially careful to check the accuracy of their prescriptions at the beginning of each month. If this is done, it seems plausible that some lives will be saved.”

Phillips’ coauthors are Jason R. Jarvinen, sociology student, UCSD, and Rosalie Phillips, executive director of the Tufts Health Care Center, Tufts University

Inga Kiderra | EurekAlert!
Further information:
http://www.ucsd.edu

More articles from Health and Medicine:

nachricht Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign

nachricht Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Helmholtz International Fellow Award for Sarah Amalia Teichmann

20.01.2017 | Awards Funding

An innovative high-performance material: biofibers made from green lacewing silk

20.01.2017 | Materials Sciences

Ion treatments for cardiac arrhythmia — Non-invasive alternative to catheter-based surgery

20.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>