Errors in prescribing injectable anticancer drugs: benefits of a pharmaceutical long-term monitoring to improve patient safety in a European comprehensive cancer centre

Abstract

ObjectivesWe aimed to assess the impact of pharmacist interventions on injectable chemotherapy prescription and the safety of early prescription practice in an adult daily care unit.MethodsPrescription errors were recorded before and after implementing corrective measures. Errors identified from the pre-intervention period (i) were analysed to identify areas for improvement. During the post-intervention period (ii) we compared the errors in anticipated prescription (AP) with those in real-time prescriptions (RTP). We performed Chi-square statistical tests (α=0.05).ResultsBefore implementing corrective measures (i), 377 errors were recorded (ie, 3.02% of prescriptions). After the implementation of corrective measures (ii), there was a significant decrease in errors, with 94 errors recorded (ie, 1.20% of prescriptions). The error rate in AP and RTP groups was 1.34% and 1.02%, respectively, without a significant difference between the two groups.ConclusionsThis study highlights the importance of prescription review, as well as collaboration between pharmacists and physicians, in reducing prescription errors, whether these prescriptions were anticipated or not.

Advanced prescription of injectable anticancer drugs: Safety assessment in a European Comprehensive Cancer Centre using the risk matrix approach

“…Considering the complexity of cancer management, with more and more available treatments, often with several drugs combined, it has become a priority for hospitals to be able to reduce patient waiting times, both for operational needs and patient comfort 33 . Advanced prescription and therefore advanced production are both potential levers for achieving these objectives, 23,34,35 but not without risks 17 …”

“…A follow‐up of prescription nonconformities is also carried out daily with traceability in Excel® (Microsoft) and also presented during this EFC. Improvement measures are therefore regularly proposed to guarantee patient safety 17 …”

“…Prescription errors in antineoplastic treatment are regularly detected by clinical pharmacists 17 and consist of wrong dose, drug omission, wrong drug, frequency error and wrong treatment duration, wrong patient, wrong administration rate and wrong administration route 18 . Some of these prescription errors could be classified as potential ADEs and could lead to reduced treatment efficacy or increased toxicity 19 .…”

“…This generates a clinical risk for the patient and an economic risk through the loss of advanced preparations 26 . Advanced prescription of injectable anticancer drugs is used in our European Comprehensive Cancer Centre, which receives an average of 100 outpatients a day, but not without risks 17 . In this context, we report here an a priori risk analysis focusing on the advanced prescription of injectable anticancer drugs in an adult day oncology care unit, using the risk matrix approach, also called RMA 27–31 …”