Drug errors more likely for liquid medicines

Patients in care homes are four times as likely to receive incorrect medication dose if delivered in a liquid form compared to tablets or capsules, according to UK research.

Mistakes with liquid medicines occurred 4.3-fold more times than tablets or capsules delivered by monitored dosage systems (MDSs).

Researchers writing in BMJ Quality and Safety found error rates were 19 times higher with the use of creams, injections or eye drops, and 33 times higher when inhalers were used. There is a ‘clear need’ for care home staff to receive additional medication training to reduce error rates, they concluded.

In the study, researchers examined data from 55 UK care homes and 233 patients. Pharmacists observed two drug rounds in each setting and noted error rates.

Just over half (53%) of observed administrations were in tablet or capsule form using MDS. Tablets and capsules not in MDSs accounted for 29.3%, liquids 11.9% and inhalers 3.8%.

Results showed there was an average of one medication administration error for every 24 residents given MDSs tables or capsules. Non-MDS administered pills and capsules were more than twice as likely to lead to administration errors than those from MDS.

The error rate was highest when inhalers were used, with 1.13 errors per patient.

Researchers said: 'Half of all inhaler administrations were incorrect, and this represents a highly significant loss of potential clinical benefit, which may reduce quality of life owing to untreated respiratory disease (and represent a significant waste of NHS money).'

They added that a study designed to assess the full impact of MDS is needed, preferably an RCT.

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