Chemotherapy medication errors

Weingart, Saul N.; Zhang, Lulu; Sweeney, Megan; Hassett, Michael J.

doi:10.1016/s1470-2045(18)30094-9

Cited by 155 publications

(172 citation statements)

References 74 publications

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“…The most rigorously conducted studies reported single‐institution medication error rates of 4%‐7% among adult cancer patients . Only 1%‐2% had the potential for harm, and the majority of errors among patients undergoing cancer treatment were due to non‐chemotherapy medications . Of those potentially harmful errors, still fewer reached the patient and resulted in a preventable injury.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Only 1%-2% had the potential for harm, and the majority of errors among patients undergoing cancer treatment were due to non-chemotherapy medications. 5 Of those potentially harmful errors, still fewer reached the patient and resulted in a preventable injury. If our estimates are accurate, then previous studies of cancer treatment-related errors may have underestimated the rate of preventable treatment-related AEs by at least an order of magnitude.…”

Section: Notementioning

confidence: 99%

“…Only three high‐quality studies of chemotherapy errors have been published to date, and virtually all patient safety‐related research performed in oncology settings has been conducted in regional or national referral centers . A literature review examining high‐quality studies of medication errors related to chemotherapy concluded that our ability to measure errors and injuries across the continuum of cancer care is poor at best …”

Section: Introductionmentioning

confidence: 99%

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Developing a cancer‐specific trigger tool to identify treatment‐related adverse events using administrative data

et al. 2020

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Background As there are few validated tools to identify treatment‐related adverse events across cancer care settings, we sought to develop oncology‐specific “triggers” to flag potential adverse events among cancer patients using claims data. Methods 322 887 adult patients undergoing an initial course of cancer‐directed therapy for breast, colorectal, lung, or prostate cancer from 2008 to 2014 were drawn from a large commercial claims database. We defined 16 oncology‐specific triggers using diagnosis and procedure codes. To distinguish treatment‐related complications from comorbidities, we required a logical and temporal relationship between a treatment and the associated trigger. We tabulated the prevalence of triggers by cancer type and metastatic status during 1‐year of follow‐up, and examined cancer trigger risk factors. Results Cancer‐specific trigger events affected 19% of patients over the initial treatment year. The trigger burden varied by disease and metastatic status, from 6% of patients with nonmetastatic prostate cancer to 41% and 50% of those with metastatic colorectal and lung cancers, respectively. The most prevalent triggers were abnormal serum bicarbonate, blood transfusion, non‐contrast chest CT scan following radiation therapy, and hypoxemia. Among patients with metastatic disease, 10% had one trigger event and 29% had two or more. Triggers were more common among older patients, women, non‐whites, patients with low family incomes, and those without a college education. Conclusions Oncology‐specific triggers offer a promising method for identifying potential patient safety events among patients across cancer care settings.

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Section: Discussionmentioning

confidence: 99%

Section: Notementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Developing a cancer‐specific trigger tool to identify treatment‐related adverse events using administrative data

et al. 2020

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“…Prescribing errors are common, but largely can be prevented before drug administration to the patient if appropriate safety structures are in place. Clinical pharmacists play a pivotal role in this error avoidance, designing safety structures and teaching other health care staff …”

Section: Discussionmentioning

confidence: 99%

“…Clinical pharmacists play a pivotal role in this error avoidance, designing safety structures and teaching other health care staff. 9,14,17 A combination of professional education, informatics, and financial incentives for prescription screening have been shown to improve the prescribing safety of nonsteroidal anti-inflammatory drugs and selected antiplatelet agents in primary care. 22 This approach demonstrates parallels with the successful error prevention strategy at FUMC, at which a CPOE tool for chemotherapy ordering is used and an additional clinical accuracy check is performed by a pharmacovigilance team.…”

Section: Discussionmentioning

confidence: 99%

Avoiding chemotherapy prescribing errors: Analysis and innovative strategies

Reinhardt

Otte

Eggleton

et al. 2019

Cancer

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Background At Freiburg University Medical Center, chemotherapy prescriptions are processed via a computerized physician order entry (CPOE) tool and clinically checked by a designated chemotherapy surveillance team. Any error detected is reported instantly, corrected, and prospectively recorded. The objective of the current study was to gain insight into the causes, potential consequences, and future preventability of chemotherapy prescribing errors. Methods A detailed analysis of 18,823 consecutive antineoplastic orders placed in 2013 through 2014 was performed. In cooperation with information technology (IT) specialists, the intercepted errors were analyzed for effective future prevention using IT measures. Potential error consequences were determined by case discussions between pharmacists and physicians. Results Within 24 months, a total of 406 chemotherapy prescribing errors were intercepted that affected 375 (2%) of the total orders. Errors were classified as clinically relevant in 279 of the chemotherapy orders (1.5%). In these cases, reduced therapeutic efficacy (0.44%), the need for increased monitoring (0.48%), prolonged hospital stay (0.55%), and fatality (0.02%) were avoided as potential consequences. The most efficient conventional measures for error prevention comprised checking the order history and patient’s medical record, and a detailed knowledge of chemotherapy protocols. Of all the errors analyzed, 61% would be avoided through further software development. The improvements identified are implemented through a validated next‐generation CPOE tool. Conclusions The upgraded CPOE tool can be shared across other hospitals to raise safety standards and spread potential benefits across a wider patient population. The current analysis also highlighted that approximately 30% to 40% of errors cannot be avoided electronically. Therefore, pharmacovigilance initiatives remain indispensable.

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Apoptosis‐Sensitizing Tumor Nanomedicine by Regulating Pyroptosis‐Associated Inflammatory Cell Death

Du,

Zhao,

Song

et al. 2024

Adv Funct Materials

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The vigorous development of cancer nanomedicine has revolutionized traditional oncology medicine, but it is also limited by the continuous mutation of cunning cancer cells, leading to apoptosis insensitivity and therapeutic disappointment. Inflammatory‐regulated cell death (RCD), especially pyroptosis‐related cell death, demonstrates huge potential for apoptosis sensitization due to its unique biochemical characteristics. The aim of this research is to present a thorough synopsis of the current knowledge on pyroptosis‐associated inflammatory cell death, including pyroptosis, cuproptosis, and PANoptosis, and the synergistic function in cancer nano therapy. Paradigm studies of pyroptosis‐related cell death‐mediated apoptosis‐sensitizing tumor nanotherapeutics are introduced in detail, and the coordination mechanisms based on nanomaterials are also discussed. In addition, multi‐angle analysis of the future prospects of pyroptosis‐sensitized tumor nanomedicine based on various nanomaterials is also emphasized to further expand the application scope of inflammatory RCD. It is believed that emerging auxiliary apoptosis‐sensitizing treatments based on inflammatory RCD will greatly promote the progress of cancer nanomedicine.

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Chemotherapy medication errors

Cited by 155 publications

References 74 publications

Developing a cancer‐specific trigger tool to identify treatment‐related adverse events using administrative data

Developing a cancer‐specific trigger tool to identify treatment‐related adverse events using administrative data

Avoiding chemotherapy prescribing errors: Analysis and innovative strategies

Apoptosis‐Sensitizing Tumor Nanomedicine by Regulating Pyroptosis‐Associated Inflammatory Cell Death

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