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Chemotherapy errors rare, but have potential for serious consequences

About one out of 30 chemotherapy orders at three ambulatory infusion clinics had errors, and one in 50 orders had a serious error, according to a study appearing in the December 1, 2005 issue of CANCER (http://www.interscience.wiley.com/cancer-newsroom), a peer-reviewed journal of the American Cancer Society. The study, performed at the Dana-Farber Cancer Institute, found most but not all errors were detected before they reached the patient. None was life-threatening or caused patient harm. Still, an accompanying editorial says the study underscores the need to implement safer controls of drug ordering and dispensing at chemotherapy infusion clinics.

Medication errors in hospitals are a stark reminder of the potential harm that can occur when patients are admitted to the hospital. While most medications are well tolerated, a few classes are toxic and require complex dosing regimens, such as those used in chemotherapy. Even a low error rate from these medications could potentially lead to significant harm, including death.

Aside from a few case reports in journals and popular media, little research has investigated the error rate of chemotherapy orders at outpatient clinics or hospitals. Some individual institutions that have been affected by these reported errors, such as the Dana-Farber Cancer Institute (a member of the Dana-Farber/Harvard Cancer Center, a National Cancer Institute-designated comprehensive cancer center), have made extensive changes to prevent such errors, such as computerization of the medication ordering system.

Led by Tejal K. Gandhi, M.D., M.P.H. and Sylvia B. Bartel, R.Ph., M.H.P., researchers from the Brigham and Women's Hospital, the Dana-Farber Cancer Institute, and the Harvard School of Public Health reviewed over 10,100 medication orders from one pediatric and two adult ambulatory clinics, which used either a paper or computerized medication ordering
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Contact: David Greenberg
dgreenbe@wiley.com
201-748-6484
John Wiley & Sons, Inc.
24-Oct-2005


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