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Liquid drug errors "more likely"

The wrong dose of medicine is more likely to be given to care home residents when it is in liquid form, research has revealed.

Residents are more than four times as likely to get an incorrect dosage from liquids than if they are given pills from a dispenser, the research published online in BMJ Quality and Safety reveals.

Monitored dosage system (MDS) dispensers are made up of compartments specifying which doses need to be taken on a particular day or at a certain time.

These are aimed at slashing the risks of drug dosage mistakes and making prescription rounds easier for staff.

However, some elderly people may require their medication in liquid form due to swallowing issues. Dispensers cannot be used with cancer drugs, or medication that must be refrigerated, injected or inhaled.

Most care homes, therefore, usually use two parallel systems of drug administration, say the study authors, who set out to compare the dosing error rates in these systems.

Included in the research were 233 residents in 55 UK care homes, which were selected to provide a representative sample of different sizes, ownership and type of care offered.

Dosing errors were picked up during the course of two drug rounds for each of the residents and from data collected from error reports from a recent previous study of the same group of care home residents.

Tablets or capsules in dispensers accounted for more than half (53%) of medicines given to the residents, with just under a third (29%) of pills not provided in dispensers. Around one in nine drugs was in liquid form and around 4% were inhalers. The remainder were injectable, creams or eye drops.

The results showed that mistakes were more than four times as likely to be made with a liquid medicine as they were with a tablet or capsule from a dispenser.

And the likelihood of a mistake was 19 times higher when using a cream, injection or eye drop, and more than 33 times as likely when an inhaler was used.

Although the error rate was lower, mistakes were also made with tablets or capsules. The rate was twice as high for tablets or capsules provided in the manufacturer's original packing as it was for pills provided in a dispenser.

Copyright © Press Association 2011

BMJ Quality and Safety

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"Drug calculations should be part of nurse training and regular updates will help to reduce the dosing errors" - Jemma Barnaby, Croydon