title: Computerized physician order entry of injectable antineoplastic drugs: an epidemiologic study of prescribing medication errors.
abstract: OBJECTIVE
  In the context of CPOE of standardized antineoplastic drugs, the objectives of the present study were to determine the incidence of prescribing medication errors (PME) and to analyse PME related to antineoplastic treatment in university teaching hospitals.
  
  
  METHODS
  All consecutive prescribing medication orders over 1 year were analysed prospectively. Potential clinical impact was quoted according to the Hatoum scale and risk factors identified with a logistic-regression model.
  
  
  RESULTS
  A total of 14,854 prescriptions were analysed. The PME incidence was estimated at 1.5% [1.3-1.7], i.e. 15 errors per 1000 prescribing medication orders, with a significant or very significant potential clinical impact in 62.9% of cases. Potentially death-threatening events were avoided in 3.7% of cases. Overall, PME incidence related to significant, very significant or vital potential clinical impact was estimated to be 1.0% [0.8-1.2], i.e. 10 errors per 1000 prescribing medication orders. The most common type of error was related to antineoplastic drug dosage (61.0%): inadequate adaptation (43.1%), not taking alarms into account (16.1%), incorrect weight (0.9%), incorrect unit (0.9%). More than 20% of PME are medication errors directly linked to the prescribing medication order (choice of antineoplastic treatment, double-prescribing medication order, forgotten or not validated by a resident or senior physician). Occasional users of the CPOE system and resident physicians were identified as main PME risk factors.
  
  
  CONCLUSIONS
  An epidemiologic survey of PME in the context of the use of a partial CPOE has allowed to determine the incidence and epidemiology of PME as well as the potential clinical impact they represent. Two risk factors have emerged that can be considered from an organization and software points of view. Better pharmacist's analysis of prescribing medication order within the CPOE system could possibly minimize duplication of antineoplasic drugs and the vital clinical impact associated with overdosage.
authors.affiliation: Department of Pharmacy, Jean Minjoz University Teaching Hospital, Besançon, France.
authors.forename: V
authors.initials: V
authors.lastname: Nerich
authors.forename: S
authors.initials: S
authors.lastname: Limat
authors.forename: M
authors.initials: M
authors.lastname: Demarchi
authors.forename: C
authors.initials: C
authors.lastname: Borg
authors.forename: P S
authors.initials: PS
authors.lastname: Rohrlich
authors.forename: E
authors.initials: E
authors.lastname: Deconinck
authors.forename: V
authors.initials: V
authors.lastname: Westeel
authors.forename: C
authors.initials: C
authors.lastname: Villanueva
authors.forename: M C
authors.initials: MC
authors.lastname: Woronoff-Lemsi
authors.forename: X
authors.initials: X
authors.lastname: Pivot
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged
chemical_list: D000970:Antineoplastic Agents