Open Access Highly Accessed Research article

Chemotherapeutic errors in hospitalised cancer patients: attributable damage and extra costs

Florence Ranchon1, Gilles Salles2, Hans-Martin Späth3, Vérane Schwiertz4, Nicolas Vantard4, Stéphanie Parat4, Florence Broussais5, Benoît You6, Sophie Tartas7, Pierre Jean Souquet8, Claude Dussart9, Claire Falandry6, Emilie Henin10, Gilles Freyer6 and Catherine Rioufol11*

Author Affiliations

1 Hospices Civils de Lyon, Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, Pierre Bénite - Université Lyon 1, Ecole Doctorale Interdisciplinaire Sciences Santé, Lyon, France

2 Hospices Civils de Lyon, Groupement Hospitalier Sud, Department of Haematology, Pierre Bénite. Université Lyon 1, UMR5239 CNRS -ENS, Lyon, France

3 Université Lyon 1, EA 4129 « Santé Individu et Société », Lyon, France

4 Hospices Civils de Lyon, Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, Pierre Bénite, France

5 Hospices Civils de Lyon, Groupement Hospitalier Sud, Department of Haematology, Pierre Bénite, France

6 Hospices Civils de Lyon, Groupement Hospitalier Sud, Department of Oncology, Pierre Bénite- Université Lyon 1, EMR UCBL/HCL 3738, Lyon, France

7 Hospices Civils de Lyon, Groupement Hospitalier Sud, Department of Oncology, Pierre Bénite, France

8 Hospices Civils de Lyon, Groupement Hospitalier Sud, Department of Pneumology, Pierre Bénite, France

9 Hôpital d'Instructions des Armées Desgenettes, Department of pharmacy, Lyon - Université Lyon 1, Ecole Doctorale Interdisciplinaire Sciences Santé, Lyon, France

10 Université Lyon 1, EMR UCBL/HCL 3738, France

11 Hospices Civils de Lyon, Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, Pierre Bénite - Université Lyon 1, EMR UCBL/HCL 3738, Lyon, France

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BMC Cancer 2011, 11:478  doi:10.1186/1471-2407-11-478

Published: 8 November 2011

Abstract

Background

In spite of increasing efforts to enhance patient safety, medication errors in hospitalised patients are still relatively common, but with potentially severe consequences. This study aimed to assess antineoplastic medication errors in both affected patients and intercepted cases in terms of frequency, severity for patients, and costs.

Methods

A 1-year prospective study was conducted in order to identify the medication errors that occurred during chemotherapy treatment of cancer patients at a French university hospital. The severity and potential consequences of intercepted errors were independently assessed by two physicians. A cost analysis was performed using a simulation of potential hospital stays, with estimations based on the costs of diagnosis-related groups.

Results

Among the 6, 607 antineoplastic prescriptions, 341 (5.2%) contained at least one error, corresponding to a total of 449 medication errors. However, most errors (n = 436) were intercepted before medication was administered to the patients. Prescription errors represented 91% of errors, followed by pharmaceutical (8%) and administration errors (1%). According to an independent estimation, 13.4% of avoided errors would have resulted in temporary injury and 2.6% in permanent damage, while 2.6% would have compromised the vital prognosis of the patient, with four to eight deaths thus being avoided. Overall, 13 medication errors reached the patient without causing damage, although two patients required enhanced monitoring. If the intercepted errors had not been discovered, they would have resulted in 216 additional days of hospitalisation and cost an estimated annual total of 92, 907€, comprising 69, 248€ (74%) in hospital stays and 23, 658€ (26%) in additional drugs.

Conclusion

Our findings point to the very small number of chemotherapy errors that actually reach patients, although problems in the chemotherapy ordering process are frequent, with the potential for being dangerous and costly.