Impact of Emerging Technologies on Medication Errors and Adverse Drug Events

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Emerging technologies

Impact of emerging technologies on medication errors and adverse drug events

EYAL OREN, ELLEN R. SHAFFER, AND B. JOSEPH GUGLIELMO

n 1999 the death rate associated with medication errors was estimated at 7000 per year.1 Of medication errors considered preventable, over half result in adverse drug events (ADEs).2 ADEs are defined as “any response to a drug which is noxious, unintended, and which occurs at doses normally used in humans for the prophylaxis, diagnosis, or therapy of disease.”3 A recent meta-analysis found a 6.7% incidence of serious adverse drug reactions in hospitals.4 In the Medical Practice Study, ADEs accounted for 14.1% of all seriously disabling adverse events.5 Classen et al.6 calculated the excess cost of hospitalization attributable to an ADE to be $2013, while others suggest the figure to be even greater, particularly for preventable ADEs.7 An estimated 28–56% of ADEs are considered preventable.6-9 Medication errors due to illegible handwritten prescriptions, overlooked allergies and drug interactions, and incorrect dosages often result in ADEs. Consequently, technology-based interventions have been recommended as a key mechanism for reducing the likelihood of medication errors and ADEs.10 Computerized physician order entry (CPOE) has been endorsed as one of three initial methods that

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Abstract: Published evidence on the effects of computerized physician order entry (CPOE), automated dispensing machines (ADMs), bar coding, and computerized medication administration records (CMARs) on medication errors and adverse drug events (ADEs) were reviewed. Emerging technologies have been recommended as potential mechanisms for reducing medication errors. Critical evaluations of the impact of these new technologies on medication errors and other adverse outcomes are lacking. PubMed was searched to identify all peer-reviewed publications linking four technologies (CPOE, ADMs, bar coding, and CMARs) with...