Medication errors with the use of allopurinol and colchicine: a retrospective study of a national, anonymous Internet-accessible error reporting system.
OBJECTIVE
To more closely assess medication errors in gout care, we examined data from a national, Internet-accessible error reporting program over a 5-year reporting period.


METHODS
We examined data from the MEDMARX database, covering the period from January 1, 1999 through December 31, 2003. For allopurinol and colchicine, we examined error severity, source, type, contributing factors, and healthcare personnel involved in errors, and we detailed errors resulting in patient harm. Causes of error and the frequency of other error characteristics were compared for gout medications versus other musculoskeletal treatments using the chi-square statistic.


RESULTS
Gout medication errors occurred in 39% (n = 273) of facilities participating in the MEDMARX program. Reported errors were predominantly from the inpatient hospital setting and related to the use of allopurinol (n = 524), followed by colchicine (n = 315), probenecid (n = 50), and sulfinpyrazone (n = 2). Compared to errors involving other musculoskeletal treatments, allopurinol and colchicine errors were more often ascribed to problems with physician prescribing (7% for other therapies versus 23-39% for allopurinol and colchicine, p < 0.0001) and less often due to problems with drug administration or nursing error (50% vs 23-27%, p < 0.0001).


CONCLUSIONS
Our results suggest that inappropriate prescribing practices are characteristic of errors occurring with the use of allopurinol and colchicine. Physician prescribing practices are a potential target for quality improvement interventions in gout care.
Department of Medicine, University of Nebraska Medical Center, Omaha, USA.
Ted R
TR
Mikuls
Jeffrey R
JR
Curtis
Jeroan J
JJ
Allison
Rodney W
RW
Hicks
Kenneth G
KG
Saag
D016907:Adverse Drug Reaction Reporting Systems; D000493:Allopurinol / Q000627:therapeutic use*; D003078:Colchicine / Q000627:therapeutic use*; D006073:Gout / Q000188:drug therapy*; D006074:Gout Suppressants / Q000627:therapeutic use*; D020407:Internet; D008508:Medication Errors / Q000706:statistics & numerical data*; D012189:Retrospective Studies
D006074:Gout Suppressants; D000493:Allopurinol; D003078:Colchicine