Economic analysis of the prevalence and clinical and economic burden of medication error in England

Abstract

ObjectivesTo provide national estimates of the number and clinical and economic burden of medication errors in the National Health Service (NHS) in England.MethodsWe used UK-based prevalence of medication errors (in prescribing, dispensing, administration and monitoring) in primary care, secondary care and care home settings, and associated healthcare resource use, to estimate annual number and burden of errors to the NHS. Burden (healthcare resource use and deaths) was estimated from harm associated with avoidable adverse drug events (ADEs).ResultsWe estimated that 237 million medication errors occur at some point in the medication process in England annually, 38.4% occurring in primary care; 72% have little/no potential for harm and 66 million are potentially clinically significant. Prescribing in primary care accounts for 34% of all potentially clinically significant errors. Definitely avoidable ADEs are estimated to cost the NHS £98 462 582 per year, consuming 181 626 bed-days, and causing/contributing to 1708 deaths. This comprises primary care ADEs leading to hospital admission (£83.7 million; causing 627 deaths), and secondary care ADEs leading to longer hospital stay (£14.8 million; causing or contributing to 1081 deaths).ConclusionsUbiquitous medicines use in health care leads unsurprisingly to high numbers of medication errors, although most are not clinically important. There is significant uncertainty around estimates due to the assumption that avoidable ADEs correspond to medication errors, data quality, and lack of data around longer-term impacts of errors. Data linkage between errors and patient outcomes is essential to progress understanding in this area.

Incidence and prevalence of intravenous medication errors in the UK: a systematic review

“…The epidemiology and aetiology of medication errors are multifactorial and poorly understood, and we believe that this is the first systematic review specific to intravenous medication administration errors in the UK. This review is timely in that it comes after the publication of the Department of Health review of the prevalence of medication errors in the NHS in England 25…”

“…Moreover, the results of this focused review broadly align with the findings of other work. Elliott et al 25 identified that medication administration errors account for 54% of medication errors overall in England. Furthermore, Elliott’s review identified the elderly and children and young people as at-risk groups.…”

Patient Safety in Outpatient Care: Results of A Multicenter Cross-Sectional Study About Medication Errors and Medication Management

“…The WHO estimates that half of all drugs are incorrectly prescribed, stored, administered or used [6]. Studies have shown that up to 30% of patients are exposed to a potential medication error, and that half of these errors occur during administration of the drug [2,7,8]. In outpatient care, speci c medication errors include taking the wrong dose or quantity of a particular drug as well as omission of a drug or taking unlicensed drugs [9].…”

“…In England it is estimated that over 237 million medication errors occur every year. This incurs extra costs of approximately 108 million euros for the NHS, as longer hospital stays or admissions are necessary [8,14]. In Germany, the annual costs incurred by medication errors are estimated to be over one billion euros [15].…”

High‐risk medicines associated with clinically relevant medication‐related problems in UK hospitals: A prospective observational study

“…Medicines are integral to the prevention, treatment and management of health, but there is growing evidence of a need to improve medication safety . Regarding hospitalised patients in England, it has been estimated that the prescribing error rate is almost 9%, and that 1 in 7 patients experience harm from their medicines …”