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Errors in prescribing include irrational, inappropriate, and ineffective prescribing, underprescribing and overprescribing (collectively called prescribing faults) and errors in writing the prescription (including illegibility).
From 1983 to 1993 the numbers of deaths from medication errors and adverse reactions to medicines used in US hospitals increased from 2876 to 7391 These increases are not surprising—in recent years hospitals have seen increased throughput of patients, new drugs have emerged that are increasingly difficult to use safely and effectively, medical care has become more complex and specialized, and the population has aged, factors that tend to increase the risk of medication errors.
The best way to understand how medication errors happen and how to avoid them is to consider their classification, which can be contextual, modal, or psychological.
The term ‘adverse drug event’ is sometimes used to describe this, but it is a bad term and should be avoided.
If an adverse event is not attributable to a drug it remains an adverse event; if it may be attributable to a drug it becomes a suspected ADR.
Of those, only ∼0.1% were thought to be clinically important, giving an annual incidence of such errors of about 50 000.
Wrong label information and instructions were the most common types of errors.an accident or unplanned pregnancy), or any unexpected deterioration in a concurrent illness’.If an adverse event occurs while an individual is taking a drug it could be an adverse drug reaction (ADR).However, it is important to detect them, since system failures that result in minor errors can later lead to serious errors.Reporting of errors should be encouraged by creating a blame-free, non-punitive environment.An ADR is ‘an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product’.Some medication errors result in ADRs but many do not; occasionally a medication error can result in an adverse event that is not an ADR (for example, when a cannula penetrates a blood vessel and a haematoma results).However, it is important to detect medication errors, whether important or not, since doing so may reveal a failure in the treatment process that could on another occasion lead to harm.There is also evidence that the death rate from medication errors is increasing.Medication (the process) is the act of giving a medication (the object) to a patient for any of these purposes.This definition reminds us of the distinction between the drug itself (the active component) and the whole product, which also contains supposedly inactive excipients.