Medication errors in type 2 diabetes from patients’ perspective

Abstract

Introduction Drug errors pose a major health hazard to a number of patient populations. However, patients with type 2 diabetes mellitus seem especially vulnerable to this risk as diabetes mellitus is usually concomitant with various comorbidities and polypharmacy, which present significant risk factors for the occurrence of drug errors. Despite this fact, there is little data on drug errors from patients’ perspective. The present survey aimed to examine the viewpoints of patients with type 2 diabetes mellitus regarding their experiences with medication errors, the overall treatment satisfaction, and their perceptions on how a medication error was handled in daily hospital routine. Materials and methods Inpatients at the Department of Endocrinology and Diabetology of the University Hospital of Graz were included in the survey. Out of 100 patients, one-half had insulin therapy before hospitalization while the other half had no insulin therapy prior to admission. After giving informed consent, patients filled out a questionnaire with 22 items. Results Independent of their preexisting therapy, 25% of patients already suffered at least one drug error, whereby prescribing a wrong dose seemed to be the most common type of error. Furthermore, 26% of patients in the non-insulin versus 50% in the insulin group (p = 0.084) were convinced that drug errors were addressed honestly by the medical staff, while 54% in the non-insulin versus 80% in the insulin-group (p = 0.061) assumed that adequate measures were taken to prevent drug errors. Finally, 9 out of 10 patients seemed satisfied with their treatment regardless of their diabetes therapy. Discussion/conclusion The results of the survey clearly showed that patients experienced at least one medication error during hospitalization. However, these errors only rarely led to patient harm. The survey also revealed the value of an honest and respectful doctor-patient relationship regarding patient perception of medication errors and general complaints. Increasing patient awareness on the existing in-hospital error management systems could eliminate treatment-related concerns and create a climate of trust that is essential for effective treatment.

Drug-related problems in hospitalized patients with type 2 diabetes mellitus: A systematic review

“… 18 cases of drug doses too low and 18 cases of drug doses too high. Hussain et al, 2019 27 India Helper Strand classification Lexicomp Micromedex Aspirin, clopidogrel, warfarin, atorvastatin and some drugs acting on the CNS- DDI Antihypertensives- ADR 99 patients (81%) experience DDI Indriani et al, 2019 28 Indonesia PCNE American Standards of Medical Care in Diabetes 2018 Drug Interaction Drug Information Handbook Indonesian Endocrinology Society – Most common DRPS is drug interactions that is 94.62% Nzayisenga et al, 2019 29 Africa PCNE Antihypertensive (270/385) Antidiabetics (267/385) Mainly drug/dose selection The prevalence of DRPs was 81.29% (313/385) Acharya et al, 2020 30 India Pharmaceutical Care Network Europe (PCNE) classification Helper Strand classification Micromedex Medscape Lexicomp Drugs.com Metformin + ciprofloxacin 2 Insulin 226 DRPs with an average of 0.91 DRP per patient Inamdar et al, 2020 31 India PCNE Metformin + Metoprolol 64 (33.16%) Metformin + Ranitidine 51 (26.42%) 278 DRPs were identified after assessing 107 study Sharma et al, 2020 32 India Beers Criteria 2019 Short-acting insulin Glimepiride PPI- PIM Clonazepam 58 (38.7%) patients were prescribed at least one PIM, 37 (24.7%) were prescribed two PIMs, and 16 (10.7%) were prescribed ≥ three PIMs Mader et al, 2022 33 Austria No reference (survey study from patient perspective) – 25% of patients already suffered at least one drug error, whereby prescribing a wrong dose seemed to be the most common type of error Nigussie et al, 2022 34 Pakistan Cipolle's DRP classification Biguanides (64) Insulin (61) The overall prevalence of inappropriate anti-diabetic medication therapy was 70.3% …”

“…, 28 India, 20 , 27 , 30. , 31 , 32 Japan, 18 and Pakistan, 34 followed by Europe (15%): Italy, 15 Poland, 19 Austria, 33 Africa (5%) 29 and North America (5%). 16 The majority of the studies were conducted in the general hospital ward with only 2 studies reported to have been conducted in the endocrinology and diabetology department.…”

“… 16 The majority of the studies were conducted in the general hospital ward with only 2 studies reported to have been conducted in the endocrinology and diabetology department. 19 , 33 …”

“… 15 , 16 , 18 , 23 , 24 Two studies used surveys or questionnaires as means of collecting data on DRPs from the patient. 20 , 33 Two studies do not provide information on methods of detecting DRPs. 19 , 22 In all of the 20 studies, a total of 27 sources of information were used to detect and classify DRPs.…”

“… 16 No available sources were mentioned in four studies. 15 , 19 , 26 , 33 Micromedex was the most used source of information ( n = 3) 24 , 27 , 30 followed by Lexicomp ( n = 2) 27 , 30 and American Diabetes Association (n = 2). 22 , 28 …”