The UK’s National Health Service (NHS) makes hundreds of millions of prescribing errors and mix-ups which contribute to as many as 22,300 deaths a year. This is according to a major report commissioned by the government which found that errors include failures to properly monitor patients on powerful drugs, poor communication between GPs and hospitals, and giving patients the wrong medication.
Researchers from the Universities of Sheffield, York and Manchester report that an estimated 712 per year deaths result from avoidable ADRs. However, researchers say that ADRs could be a contributory factor to between 1,700 and 22,303 deaths a year.
Of the total estimated 237m medication errors that occur, researchers found that almost three in four are unlikely to result in harm to patients, but there is very little information on the harm that actually happens due to medication errors.
This led researchers to review studies related to the harm caused to patients from ADRs. As well as the number of deaths reported, they also showed that avoidable ADRs had significant cost implications, at £98.5m per year, but this could be significantly higher.
The economic impact of medication errors varied widely, from £60 per error for inhaler medication, for example, to more than £6m in litigation claims associated with anaesthetic errors. The team is calling for more work to be done on finding cost-effective ways of preventing medication errors and their potential harm to patients.
The report, which reflects on 36 studies that detail medication error rates in primary care, care homes and secondary care, showed that the most errors with potential to cause harm happen in primary care (71%), which is where most medicines in the NHS are prescribed and dispensed. Errors were more likely to occur in older people and in patients with multiple conditions and using many medicines.
Fiona Campbell, research fellow from the University of Sheffield’s School of Health and Related Research (ScHARR), said: “Measuring harm to patients from medication errors is difficult for several reasons, one being that harm can sometimes occur, when medicines are used correctly, but now that we have more understanding of the number of errors that occur we have an opportunity to do more to improve NHS systems.”
Professor of health economics at the University of York, Mark Sculpher, said: “Although these error rates may look high, there is no evidence suggesting they differ markedly from those in other high-income countries.
“Almost three in four errors would never harm patients and some may be picked up before they reach the patients, but more research is needed to understand just how many that is.”
Rachel Elliott, professor of health economics from the University of Manchester said “The NHS is a world-leader in this area of research, and this is why we have a good idea about error rates. There is still a lot to do in finding cost-effective ways to prevent medication errors.
“What this report is showing us is that we need better linking of information across the NHS to help find more ways of preventing medication errors.”
The report, funded by the UK Department of Health Policy Research Programme, will be unveiled at the World Patient Safety Science and Technology Summit and is published by the Policy Research Unit in Economics Evaluation of Health and Care Interventions (EEPRU).
Medication errors may cause harm, including death, and increase use of health care services. This project aims to summarise the evidence on the burden of medication error, namely the number of errors occurring in the NHS in England, the costs of those errors to the NHS and the health losses due to medication error. This involves two systematic reviews, one on the incidence and prevalence of medication errors, and the other on the costs of health burden associated with errors. Additionally, economic modelling estimates the number of errors occurring in the NHS in England each year, their costs and health consequences.
Rachel Elliott, Elizabeth Camacho, Fiona Campbell, Dina Jankovic, Marrissa Martyn St James, Eva Kaltenthaler, Ruth Wong, Mark Sculpher, Rita Faria