PurposeTo determine the nature and frequency of medication errors during medication delivery processes in a public teaching hospital geriatric ward in Bali, Indonesia.MethodsA 20-week prospective study on medication errors occurring during the medication delivery process was conducted in a geriatric ward in a public teaching hospital in Bali, Indonesia. Participants selected were inpatients aged more than 60 years. Patients were excluded if they had a malignancy, were undergoing surgery, or receiving chemotherapy treatment. The occurrence of medication errors in prescribing, transcribing, dispensing, and administration were detected by the investigator providing in-hospital clinical pharmacy services.ResultsSeven hundred and seventy drug orders and 7,662 drug doses were reviewed as part of the study. There were 1,563 medication errors detected among the 7,662 drug doses reviewed, representing an error rate of 20.4%. Administration errors were the most frequent medication errors identified (59%), followed by transcription errors (15%), dispensing errors (14%), and prescribing errors (7%). Errors in documentation were the most common form of administration errors. Of these errors, 2.4% were classified as potentially serious and 10.3% as potentially significant.ConclusionMedication errors occurred in every stage of the medication delivery process, with administration errors being the most frequent. The majority of errors identified in the administration stage were related to documentation. Provision of in-hospital clinical pharmacy services could potentially play a significant role in detecting and preventing medication errors.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • A number of factors have been hypothesized to increase the risk of amiodarone‐induced pulmonary toxicity (AIPT), although there remains some controversy in the literature as to their relative significance. • This study aimed to clarify this situation to permit better characterization of patients at risk of AIPT and thus guide the development of guidelines for the monitoring for AIPT in patients receiving the drug. WHAT THIS STUDY ADDS • Via compilation and analysis of a database of 237 AIPT cases, it was demonstrated that only patient age and duration of therapy significantly affected the risk of AIPT. • A small cohort of hospital AIPT patients demonstrated these ‘at‐risk’ characteristics, suggesting that targeted monitoring of patients aged >60 years and those on amiodarone for 6–12 months may enhance the safety of these patients and minimize their risk of morbidity and mortality secondary to AIPT. AIMS A number of factors have been hypothesized to increase the risk of amiodarone‐induced pulmonary toxicity (AIPT). This study aimed to confirm these risk factors and determine whether a cohort of tertiary hospital patients diagnosed with AIPT demonstrated comparable characteristics. METHODS Phase I of this study involved compilation of a database of adverse reactions to amiodarone reported to the Australian and US drug agencies, and identification of risk factors for AIPT using logistic regression analysis. In Phase II, AIPT cases were identified via a retrospective review of medical records of patients discharged from Fremantle Hospital and Health Service, Western Australia (FHHS) between 2000 and 2005 with diagnosed interstitial lung disease. Data were collected regarding these patients’ risk factors for AIPT and compared with those previously identified in Phase I. RESULTS A total of 237 cases of AIPT were identified from agency data. Patients aged > 60 years and those on amiodarone for 6–12 months (odds ratio 18.28, 95% confidence interval 6.42, 52.04) were determined to be at the highest risk of AIPT. Australian data also suggested increased risk in patients who had received cumulative doses of 101–150 g. The seven AIPT cases identified among the FHHS patients were all at high risk of AIPT based on their age and duration of amiodarone therapy. CONCLUSION Contrary to previous findings, only patient age and the duration of amiodarone therapy were confirmed as significant risk factors for AIPT. Targeted monitoring of these patients may facilitate early identification and management of AIPT.

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