A systematic review of medication administration errors with transdermal patches

Lampert, Anette; Seiberth, Jasmin Mina; Haefeli, Walter E.; Seidling, Hanna M.

doi:10.1517/14740338.2014.926888

Cited by 19 publications

(17 citation statements)

References 77 publications

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“…Almost all dosage forms were described as predictive for administration errors or nonadherence in a specific context. The use of inhalers [19], injection devices [20][21][22], transdermal patches [23] and nasal preparations [24] and even of solid [25] or liquid [26] oral dosage forms was accompanied by administration errors. Furthermore, nonadherence was described for the use of ophthalmic preparations like eye drops [27], rectal preparations [28,29] such as suppositories and enemas as well as dermatological preparations (Table 1) [30,31].…”

Section: Dosage Formsmentioning

confidence: 99%

Individual factors increasing complexity of drug treatment—a narrative review

Schmidt

Wurmbach

Lampert

et al. 2020

Eur J Clin Pharmacol

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Purpose Complexity of drug treatment is known to be a risk factor for administration errors and nonadherence promoting higher healthcare costs, hospital admissions and increased mortality. Number of drugs and dose frequency are parameters often used to assess complexity related to the medication regimen. However, factors resulting from complex processes of care or arising from patient characteristics are only sporadically analyzed. Hence, the objective of this review is to give a comprehensive overview of relevant, patient-centered factors influencing complexity of drug treatment. Methods A purposeful literature search was performed in MEDLINE to identify potential complexity factors relating to the prescribed drug (i.e. dosage forms or other product characteristics), the specific medication regimen (i.e. dosage schemes or additional instructions), specific patient characteristics and process characteristics. Factors were included if they were associated to administration errors, nonadherence and related adverse drug events detected in community dwelling adult patients. Results Ninety-one influencing factors were identified: fourteen in "dosage forms", five in "product characteristics", twelve in "dosage schemes", nine in "additional instructions", thirty-one in "patient characteristics" and twenty in "process characteristics". Conclusions Although the findings are limited by the non-systematic search process and the heterogeneous results, the search shows the influence of many factors on the complexity of drug treatment. However, to evaluate their relevance for individual patients, prospective studies are necessary.

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Section: Dosage Formsmentioning

confidence: 99%

Individual factors increasing complexity of drug treatment—a narrative review

Schmidt

Wurmbach

Lampert

et al. 2020

Eur J Clin Pharmacol

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“…One judge suggested adding the need to remove excess medication after removal of the patch. Experimental and systematic review studies have shown the risk of severe burns in cases where AED was used in patients with a nitrate drug patch, where the patch or excess medication was not withdrawn (28) .…”

Section: -Cardiac Rhythms Of Cardiopulmonary Arrest and Automatedmentioning

confidence: 99%

Construction and validation of a distance Basic Life Support Course

et al. 2018

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Objective: to describe the content construction and validation process of the Distance Education Basic Life Support Course. Method: methodological study, developed through literature review, outlined in the light of the Bloom's Taxonomy and Ausubel's Meaningful Learning Theory. For validation, the analysis was performed with judges, using a structured tool. Results: the construction of the distance course was complex and challenging, since it was tried to develop it with logical-methodological coherence, considering the constructivist perspective, representing an advance in the process of dissemination of the Urgency and Emergency teaching culture. As for the content validation process, it was verified that of the 16 suggestions made by the judges, 14 were accepted and two rejected. Conclusion: the course had its contents validated by experts.

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“…Good adhesion of a transdermal patch to the skin is essential for maximum efficacy, and adhesion failure hampers proper dosing 14. Consequently, and in the absence of any other rationale reason, skin adhesion problems may point practical reasons to explain an early replacement of fentanyl TTS and mimic end-of-dosage failure.…”

Section: Discussionmentioning

confidence: 99%

Poor adhesion of fentanyl transdermal patches may mimic end-of-dosage failure after 48 hours and prompt early patch replacement in hospitalized cancer pain patients

Arnet

Schacher

Balmer

et al. 2016

JPR

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ContextRenewal of fentanyl transdermal patch (transdermal therapeutic system [TTS]) should occur every 3 days (72 hours) according to manufacturer’s guidelines. Some studies mentioned patients reporting end-of-dose failure, and thus, some authors recommend shortening the interval of application to 2 days (48 hours). However, reasons for early replacement are mostly unknown.ObjectivesThe objectives of this study were to assess the prevalence of early replacement of fentanyl TTS in a cancer center in Basel, Switzerland, and to assess the reasons for early replacement in stationary patients.MethodsWe retrieved all fentanyl TTS administered in a cancer center in Basel, Switzerland, between November 11, 2011, and January 31, 2015, from the electronic medical database.ResultsA total of 739 patients (mean age 71.4±11.5 years, 55% women) were administered 2,250 fentanyl TTS (dosage 6–500 µg/hour). Most replacements occurred after 72 hours (61.6%) and a few after 48 hours (7.4%). Patients with early replacement after 48 hours were significantly younger (63.8 years versus 71.5 years, p<0.001) and obtained higher mean dosages of fentanyl TTS (89 µg/hour versus 44.1 µg/hour, p<0.001) and rescue medication (calculated as oral morphine equivalent in milligrams: 185.1 mg versus 39.6 mg during the first 24 hours after replacement, p<0.001). No pharmacological rationale for early replacement was observed. According to 57 physicians, nurses, and pharmacists, the most often reasons for early TTS replacement were end-of-dosage pain (41.4%) and poor adhesion (31.4%).ConclusionIn the absence of any physiological, pharmacological, or environmental reasons recorded in the database to explain an early replacement of fentanyl TTS, skin adhesion problems may point practical reasons and mimic end-of-dosage failure.

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A systematic review of medication administration errors with transdermal patches

Cited by 19 publications

References 77 publications

Individual factors increasing complexity of drug treatment—a narrative review

Individual factors increasing complexity of drug treatment—a narrative review

Construction and validation of a distance Basic Life Support Course

Poor adhesion of fentanyl transdermal patches may mimic end-of-dosage failure after 48 hours and prompt early patch replacement in hospitalized cancer pain patients

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