off record
Shaukat Ali Jawaid


 Medication administration
errors and the elderly



Elderly patients with too much co-morbidity at times have to take too many drugs and errors in medication administration could lead to serious consequences with increased morbidity and mortality. Doctors in Pakistan particularly in the public hospitals are too much overburdened where they have to see a large number of patients in the absence of any referral system. Even otherwise healthcare professionals and doctors in particular spend too little time with the patient and try to dispose of the patient writing a prescription too early without giving the patients a patient hearing. This also leads to lack of satisfaction among the patients. Even after writing the prescription most doctors do not spend enough time with the patient to educate them or their attendants how to take these medications. The problem in Pakistan is particularly acute particularly in the rural areas and urban slums where the patients are not much educated. The result is poor compliance with drug therapy, inappropriate dosage or missing certain doses during the treatment. All this is fraught with dangers and needs to be looked into.

In Pakistan geriatric services are not well developed and looking after the elderly patients at home is not so easy. In case of acute illness like stroke, even the caregivers suffer from stress and strains, depression and fatigue which make the situation even worse. These issues have been recognized in the developed world and appropriate measures are being taken to overcome this situation. Now even scientific studies have proven that medication administration errors leading to death is very common. Injectable anti-coagulants, antibiotics and analgesics are reported to be the drugs most often involved in medication administration errors. The common medication administration errors reported in a study from England and Wales include omitted medications followed by wrong dose or a wrong strength. Most of the patients who were involved were over seventy five years of age.

Researchers in this study have called for paying more attention to the safe administration of medications especially when it comes to the elderly patients. It is important for the family members taking care of these elderly patients to ensure that they get the right dose of medication at the right time in the right way. This study conducted from 2007-2016 reported 517,384 medication administration errors in the system. It resulted in two hundred twenty nine deaths in these patient. The importance of sufficient human resources and competent staff in the healthcare facilities can never be over emphasized. Proper use of technology in the healthcare facilities which ensures medication safety is yet another important intervention. However, when it comes to the care of these elderly patients at home, it is the responsibility of the family members, attendants to ensure that. Hence it is also the responsibility of the healthcare professionals to educate not only the patients but also their attendants, family members who are going to take care of them at home to eliminate or minimize these errors. The study referred above has showed the vulnerability of the elderly patients to missed medication errors and the need to be careful which will avoid the likely serious consequences for the patients and quality of care. Let us learn from the mistakes of others and do whatever we can to ensure patient safety. We also need to promote the patient safety culture in the country in our health services in particular.

Ref: Research in Social and Administrative Pharmacy (2018). Doi: https://doi.org/10.1016/j.sapharm.2018.11.010

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