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Avoiding chemotherapy prescribing errors: Analysis and innovative strategies.

Heike Reinhardt1, Petra Otte1,2, Alison G Eggleton3

  • 1Department of Hematology, Oncology, and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

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Summary

Chemotherapy prescribing errors were identified and analyzed. A next-generation computerized physician order entry (CPOE) tool can prevent 61% of these errors, enhancing patient safety in cancer care.

Keywords:
chemotherapy prescribingcomputerized physician order entryerror avoidancemedication safetypharmacovigilance

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Area of Science:

  • Oncology
  • Medical Informatics
  • Patient Safety

Background:

  • Chemotherapy prescriptions at Freiburg University Medical Center are managed through a computerized physician order entry (CPOE) system.
  • A dedicated chemotherapy surveillance team reviews orders, reporting and correcting any detected errors.

Purpose of the Study:

  • To investigate the causes, potential consequences, and future prevention strategies for chemotherapy prescribing errors.
  • To analyze intercepted errors for IT-based prevention measures.

Main Methods:

  • Analysis of 18,823 antineoplastic orders from 2013-2014.
  • Collaboration with IT specialists to identify IT-based prevention strategies.
  • Case discussions between pharmacists and physicians to determine potential error consequences.

Main Results:

  • 406 chemotherapy prescribing errors were intercepted, affecting 375 orders (2%).
  • 279 errors (1.5%) were clinically relevant, with potential consequences including reduced efficacy, increased monitoring, prolonged hospital stay, and fatality.
  • 61% of errors could be prevented by further software development, implemented via a next-generation CPOE tool.

Conclusions:

  • An upgraded CPOE tool can improve chemotherapy safety standards and be shared across hospitals.
  • Approximately 30-40% of errors remain unpreventable by electronic means, underscoring the need for ongoing pharmacovigilance.