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Researchers in NSW and the University of South Australia found opioid prescription errors are higher than previously reported in other healthcare settings, according to a paper from the British Medical Journal Supportive and Palliative Care.
The two-leading types of medication errors are missed doses and wrong doses. The study found more than 57% of patients received a lower dose of pain medicine which led to clinical intervention in a third of the cases. That’s a huge problem, because medication errors can lead to opioid abuse and contribute to underdosing of patients. Underdosing can lead to the increased pain of terminally ill patients during the last weeks of their lives.
In the study, three inpatient palliative care services in metropolitan NSW were observed for opioid errors with the majority of patients examined in their 70s, whohad terminal cancer.
Professor Debra Rowett of the University of South Australia's School of Pharmacy and Medical Sciences says the study's importance of understanding why opioid errors occur – particularly lower dosing, is that it can contribute to the pain of terminally ill patients. In fact, the study found adverse effects impacted on pain and symptom management from underdosing in 42% of patients. Of those patients, more than half of them required additional treatment as a direct consequence of the opioid error.
"Palliative care clinicians have identified that safe use of opioids is a patient safety priority and this study is an important first step in quantifying and identifying opioid errors," Professor Rowett said.
Prescription errors posed a high-risk to patient safety, especially those involving opioids. The risk amplified in elderly patients with multiple health issues and taking various medications.
The study found prescription errors were consistently under-reported and could be argued the number of medication errors could be much higher. They also argued that a better understanding of opioid errors should and the adverse impacts must be a priority in palliative care
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