At-Home Drug Errors Common for Kids With Cancer, Research Shows05/03/13
FRIDAY, May 3 (HealthDay News) -- Children with cancer often
have complex medication regimens -- sometimes as many as 20 drugs a
day -- that they take at home, and mistakes are common, a new study
Errors often occur when parents don't understand how to give the
drugs, but mislabeled bottles and wrong prescriptions are also to
blame, researchers say.
"Parents of children with cancer make many mistakes giving their children critical medicines, including chemotherapy at home," said lead researcher Dr. Kathleen Walsh, of the departments of pediatrics and medicine at the University of Massachusetts School of Medicine in Worcester.
Injuries were often related to under-dosing pain medication,
which was causing pain for the children, she said. "Sometimes
parents wouldn't fill prescriptions, or give the proper dose,"
"One thing that was surprising was the high rate of errors that go on," she added. "This high rate of errors calls us to remind doctors and parents that they need to be aware that home medication use is fraught with error, so they need to give the medicines exactly as they are told to do."
That's not to blame parents, Walsh noted. "Usually parents
weren't aware they were making mistakes. They weren't aware that
what they were doing could be dangerous or could decrease the
effectiveness of the medications they were using," she said.
Parental "workarounds" to get kids to take medicines could make
them less effective.
For example, one child wouldn't take a chemotherapy drug, so the
parent sprinkled it on his dinner not realizing the drug doesn't
work when taken with food, Walsh said.
"Another parent wasn't using a pill cutter, but using a knife to cut the medication and so the chemotherapy was crumbling and much of it was left on the table," she explained. "Parents didn't realize this was a mistake."
Walsh thinks parents need more support in how they use
medications at home. "Parents need to understand you need to give
medications exactly as prescribed and if you are going to change
that in any way you need to tell the doctor," she said.
The report was published in the May print issue of
Dr. Len Lichtenfeld, deputy chief medical officer at the
American Cancer Society, said that "when you are caught in the
middle of the chaos and sadness of a sick child, it's not uncommon
to see significant mistakes made when [parents are] giving
medications to their children."
Many of the parents in the study were college educated, but no
matter how well-educated the parents there are still many gaps in
understanding how to administer chemotherapy at home, he said.
Lichtenfeld noted that these errors weren't always the parent's
fault. "There were discrepancies between the labels on the drug and
what the parents were supposed to do," he said. It's possible that
the doctor changed the dose, but it was not reflected in the label
from the pharmacy. This problem could be solved by better labeling,
To gauge the scope of medical errors, Walsh's team visited the
homes of 92 children with cancer and watched 242 medications being
given. In addition, the team reviewed 963 prescriptions for the
correct drug and dose.
In all, they found 72 medication errors, four of which were
harmful to the child and 40 more that could have been harmful.
Two errors were classified as life-threatening, 13 as serious
and 25 as significant errors. Most of the errors were for
non-chemotherapy drugs, the researchers noted.
Another expert, Dr. Maggie Eidson, a pediatric oncologist at
Miami Children's Hospital, said that "the fact that there are
errors isn't surprising. It reminds us we need to give parents good
tools to keep their dosing regimens clear and help parents to
manage things at home better."
To learn more about childhood cancer, visit the
American Cancer Society.
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