Prevalence of Medication Errors and the Associated Factors: A Prospective Observational Study Among Cancer Patients at Mbarara Regional Referral Hospital

Abstract

Background

Medication error is one of the most common medical errors in the practice of modern medicine. Among cancer patients receiving chemotherapy, medication errors can be potentially harmful given the narrow therapeutic index, complex dosing, and toxic nature of anti-cancer drugs.

Objective

This study aimed to determine the incidence and factors associated with medication errors among cancer patients.

Methods

The study was a prospective observational study carried out at the cancer unit of Mbarara Regional Referral Hospital, Southwestern Uganda. The study included 110 participants, both adults and children receiving chemotherapy. The study was carried out for a period of five months from January to May 2020. A checklist was used to collect patient, medication, and disease information to identify the prescription, transcription, dispensing, and administration errors.

Results

Of the 110 participants, 52 (47.3%) experienced a total of 78 medication errors (MEs). Of these, 33 (42.31%) were prescription errors, 29 (37.18%) administration errors, 9 (11.54%) transcription errors, and 7 (8.97%) dispensing errors. In the adjusted logistic regression of factors associated with medication errors, urban residents (aOR, 4.59; 95% CI, 1.08, 19.53, p= 0.039) and educated participants (at secondary level) (aOR, 10.51; 95% CI, 1.43, 77.14, p= 0.021) had a significantly higher risk of experiencing medication errors. Participants treated with alkylating agents (aOR, 2.87; 95% CI, 1.07, 7.72, p= 0.036) had a greater risk of experiencing medication errors when compared to other classes of chemotherapy.

Conclusion

The incidence of medication errors among cancer patients was high in Mbarara Regional Referral Hospital. Prescription errors were the most common type of error followed by administration errors, and dispensing errors were the least common. Residence, education level, and alkylating agent chemotherapy were significantly associated with occurrence of medication errors.

Keywords:

• prevalence
• medication error
• associated factors
• cancer
• Mbarara

Acknowledgments

The authors extend their sincere gratitude toward the study participants and health workers at the cancer unit of Mbarara Regional Referral Hospital. We would like to thank the data collection assistants for cooperating with us through the data collection process.

Abbreviations

aOR, adjusted odds ratio; OR, odds ratio; DM, diabetes mellitus; HTN, hypertension; HIV, human immunodeficiency virus; CPOE, computerized physician order entry; MRRH, Mbarara University of Science and Technology; WHO, World Health Organization.

Data Sharing Statement

All the data supporting the conclusions of this article are included within this manuscript.

Ethics Approval and Consent to Participate

The study protocol was approved by the Research Ethics Committee (REC) at Mbarara University of Science and Technology as the Institutional review board for authorization to conduct the research (MUREC 1/7-2020). Informed consent was sought before recruitment of adult patients while parental or guardian consent was obtained on behalf of children below 18 years. All methods used in the study were in accordance with regulations and guidelines of the Research Ethics Committee and cancer unit of Mbarara Regional Referral Hospital.

Consent for Publication

All authors agreed to submission of this manuscript for publication in addition to the consent to publish which was included in the informed consent form which attained ethical and participant approval.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest for this work.