• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (13)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in this journal  Topic Collections  • Public Health  • Substance Abuse/ Alcoholism  • Quality of Care  • Patient Safety/ Medical Error  • Drug Therapy  • Adverse Effects  • Medication Error  • Alert me on articles by topic  Social Bookmarking   What's this?

David P. Phillips, PhD; Gwendolyn E. C. Barker, BA; Megan M. Eguchi

Arch Intern Med. 2008;168(14):1561-1566.

Background  Increasingly, medications are consumed outside of clinical settings, with relatively little professional oversight. Despite this trend, previous studies of medication errors have focused on clinical settings.

Methods  We examined all US death certificates from January 1, 1983, to December 31, 2004 (N = 49 586 156), particularly those with fatal medication errors (FMEs) (n = 224 355). We examined trends in 4 types of FMEs that vary according to the relative importance of alcohol/street drugs and the relative likelihood of professional oversight in the consumption of medications.

Results  The overall FME death rate increased by 360.5% (1983-2004). This increase far exceeds the increase in death rates from adverse effects of medications (33.2%) or from alcohol and/or street drugs (40.9%). The increase in FMEs varies markedly by type. Type 1 (domestic FMEs combined with alcohol and/or street drugs) shows the largest increase (3196%). In contrast, type 4 (nondomestic FMEs not involving alcohol and/or street drugs) shows the smallest increase (5%). Types 2 and 3 show intermediate increases. Type 2 (domestic FMEs not involving alcohol and/or street drugs) increased by 564%. Type 3 (nondomestic FMEs combined with alcohol and/or street drugs) increased by 555%. Thus, domestic FMEs combined with alcohol and/or street drugs have become an increasingly important health problem compared with other FMEs.

Conclusions  These findings suggest that a shift in the location of medication consumption from clinical to domestic settings is linked to a steep increase in FMEs. It may now be possible to reduce FMEs by focusing not only on clinical settings but also on domestic settings.

Author Affiliations: Departments of Sociology (Dr Phillips and Ms Barker) and Biology (Ms Eguchi), University of California at San Diego, La Jolla.

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

A Closer Look at Fatal Medication Errors
Tsung-Hsueh Lu
Arch Intern Med. 2009;169(7):718.
EXTRACT | FULL TEXT  

A Closer Look at Fatal Medication Errors—Reply
David P. Phillips and Gwendolyn E. C. Barker
Arch Intern Med. 2009;169(7):718-719.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Closer Look at Fatal Medication Errors
Lu
Arch Intern Med 2009;169:718-718.
FULL TEXT  

A Closer Look at Fatal Medication Errors--Reply
Phillips and Barker
Arch Intern Med 2009;169:718-719.
FULL TEXT