Medication and Dispensing Errors in Latin America

By Latin American Federation of the Pharmaceutical Industry (FIFARMA)

Have you ever wondered if you're taking your medications correctly? Do you know the consequences of incorrect prescription or administration?

At some point in our lives, we've all used medication to treat an illness. Although these medications undergo rigorous and extensive processes to ensure their safety, there are still some medication and dispensing errors that can harm patients. 

Every year, a large number of patients suffer harm or die as a result of unsafe healthcare, causing a high burden of death and disability worldwide, according to the World Health Organization (WHO). 

Keep reading to learn about these errors, their possible causes, and how to prevent them to improve the safety of medical treatments in Latin America. 

What Are They?

According to the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP), medication errors (MEs) are defined as any preventable event that may cause harm to the patient and is related to the inappropriate use of medications; while the medication is under the control of the healthcare professional, the patient, or the consumer.

Some of the most common errors include prescripción, incorrect prescription, preparation, dispensing, distribution, or dosage; and incorrect administration and consumption of medications. 

Causes and Consequences

Now that you know the most common errors, imagine this scenario:

A patient has just been admitted to the hospital due to an urgent medical condition. The doctor prescribes a vital medication for the patient, but due to the urgency of the situation, the information about the exact dosage and administration time is unclear. In the dispensing area, the pharmacist interprets the prescription differently and prepares a dose that does not match the doctor's intention. Then, during the medication administration, the nurse administers the wrong dose. 

This example can happen for various reasons. Here are some of the most common causes:

• Ineffective communication: Information is not conveyed clearly between healthcare staff and the pharmacist, and incorrect or incomplete information may even be provided to patients. Ineffective communication also involves language barriers.
• Lack of training: Some healthcare professionals do not have the necessary training to correctly address medication administration.
• Challenging healthcare systems: The healthcare infrastructure in some countries in the region may pose challenges such as limited resources, lack or excess of staff, and long working hours leading to tired healthcare professionals, increasing the likelihood of errors.

Medication errors have a detrimental impact on people's lives, causing patients to become ill or worsen their condition. Some of the consequences include:  

• Health risk: Consuming the wrong medication or an incorrect dosage can lead to hospitalization, disability, birth defects, and even death. 

• Distrust in the system: Repeated errors can undermine trust in the healthcare system, making people hesitant to seek treatment when needed.

• Economic burden:Additional treatments and unnecessary hospitalizations can generate significant costs. 

According to the World Health Organization (WHO), the social cost of patient harm can be valued at between 1 and 2 trillion dollars annually. 

Overview in Latin America

Health is invaluable, and medical care is essential to ensure the well-being of the population. However, despite efforts to provide quality medical care, Latin America faces significant challenges related to medication and dispensing errors. Research conducted in the region reveals higher rates of adverse events than those identified in developed countries. 

Available evidence indicates that hospitals in low- and middle-income countries experience 134 million adverse events and 2.6 million deaths annually (WHO, 2023). 

These figures, higher than those in developed countries, could be attributed to lower qualifications of healthcare professionals and inadequate healthcare system infrastructure. Available literature suggests that out of 20 Latin American countries analyzed, the most common errors were prescription and administration errors, as well as human errors associated with healthcare delivery. 

Specifically, the most common administration errors are related to timing, dosage, and omission. The former occurs when patients take medication at the wrong time, the second when the dosage is inaccurate or not prescribed, and the latter when the patient does not take the medication.  

However, the literature reveals a lack of standardized classification in the definitions of MEs among Latin American countries, highlighting the need to establish uniform criteria to assess and address this critical issue. For example, eight countries do not consider the definition of medication error (ME) within their official documents. Among these are Panama, Colombia, the Dominican Republic, and Venezuela. 

Medication and dispensing errors represent a critical challenge to patient safety in Latin America. Despite advances in healthcare, error rates remain significant, with potentially serious consequences for the health and well-being of the population.

Steps towards a Safer Future

How do we effectively address this problem? First and foremost, it is essential to promote ongoing research, establish regional standards, and encourage collaboration among healthcare professionals, policymakers, and healthcare institutions. 

The implementation of advanced technologies, improvement of healthcare staff training, and public awareness are also crucial steps towards a safer future in medication administration in Latin America.

A valuable resource is the Global Patient Safety Action Plan 2021-2030, led by the World Health Organization (WHO), a strategic direction for concrete measures to be adopted by countries, partner organizations, and healthcare establishments; to eliminate preventable harm in healthcare and ensure patient safety. 

In our region, it is important to heed the WHO's call to join the mission of driving policies, strategies, and actions; to eliminate all sources of preventable risk and harm. 

Now that we understand the causes and consequences of medication errors (MEs), and have reviewed the landscape in the region; we are one step closer to building a stronger and more reliable healthcare system for all. Let's continue navigating together towards a future where safety and effectiveness in healthcare are a priority. 

Sources

• https://www.who.int/publications/i/item/9789240032705
• https://revistas.udec.cl/index.php/Ergonomia_Investigacion/article/view/5214
• https://www.saludyfarmacos.org/lang/es/boletin-farmacos/boletines/nov202205/73_er/
• https://www.fda.gov/drugs/information-consumers-and-patients-drugs/working-reduce-medication-errors#:~:text=A%20medication%20error%20is%20defined,Medication%20Error%20Reporting%20and%20Prevention.