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Prevalence and Causes of Medication Errors: A Review

Following the 1999 Institute of Medicine (IOM) report titled “To Err Is Human,” much attention has been focused on medical errors. In that report, it was estimated that medical errors cost as many as 98,000 lives each year in the United States. The IOM report has spurred scientific study on the causes, consequences, and preventive strategies regarding medical errors. The current paper reviews available literature regarding these issues. MethodsA literature search was conducted using Ovid Technologies/Medline from January 1966 to March 2002. The following search terms were used:medication errors, missed medications, omitted medications, missed dose, and missed treatment. ResultsRates of different types of errors vary across series. For example, the rate with which the wrong drug was administered varies from 0% to 9%. The rate at which drugs were administered with the incorrect frequency ranged from 4% to 25%. Finally, the rate with which drugs were inadvertently omitted ranged from 1.1% to 58%. Reasons commonly cited for missing medications were patients’ unavailability, intolerance of the medication, and the clinicians’ perception that the medication was not needed. ConclusionsGreater attention to reducing medication errors is needed. Proposed strategies include implementing unit dose pharmacy systems and physician order entry systems, enhancing interdisciplinary communication, educating patients regarding their medications, and increased attention to system failures.