title: Quantifying the burden of opioid medication errors in adult oncology and palliative care settings: A systematic review.
abstract: Opioids are the primary pharmacological treatment for cancer pain and, in the palliative care setting, are routinely used to manage symptoms at the end of life. Opioids are one of the most frequently reported drug classes in medication errors causing patient harm. Despite their widespread use, little is known about the incidence and impact of opioid medication errors in oncology and palliative care settings.
  
  
  
  To determine the incidence, types and impact of reported opioid medication errors in adult oncology and palliative care patient settings.
  
  
  
  A systematic review.
  
  
  
  Five electronic databases and the grey literature were searched from 1980 to August 2014. Empirical studies published in English, reporting data on opioid medication error incidence, types or patient impact, within adult oncology and/or palliative care services, were included. Popay's narrative synthesis approach was used to analyse data.
  
  
  
  Five empirical studies were included in this review. Opioid error incidence rate was difficult to ascertain as each study focussed on a single narrow area of error. The predominant error type related to deviation from opioid prescribing guidelines, such as incorrect dosing intervals. None of the included studies reported the degree of patient harm resulting from opioid errors.
  
  
  
  This review has highlighted the paucity of the literature examining opioid error incidence, types and patient impact in adult oncology and palliative care settings. Defining, identifying and quantifying error reporting practices for these populations should be an essential component of future oncology and palliative care quality and safety initiatives.
authors.affiliation: School of Nursing, University of Notre Dame Australia, Darlinghurst Campus, Broadway, NSW, Australia nicole.heneka1@my.nd.edu.au.
authors.forename: Nicole
authors.initials: N
authors.lastname: Heneka
authors.affiliation: Research in Implementation Science and eHealth (RISe), Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Shaw
authors.affiliation: Drug and Therapeutics Information Service, Repatriation General Hospital, Adelaide, SA, Australia.
authors.forename: Debra
authors.initials: D
authors.lastname: Rowett
authors.affiliation: School of Nursing, University of Notre Dame Australia, Darlinghurst Campus, Broadway, NSW, Australia Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Phillips
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000072716:Cancer Pain / Q000188:drug therapy*; D006801:Humans; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000706:statistics & numerical data*
chemical_list: D000701:Analgesics, Opioid
keywords: Analgesics; hospital; medication errors; oncology service; opioid; palliative care; patient safety