Introduction

Medication error studies have been conducted for more than 30 years. The goals of a comprehensive study of medication errors should:

  • measure the medication error rates in given environments;
  • compare medication administration accuracy rates associated with different drug distribution systems;
  • identify causative factors associated with medication errors;
  • evaluate the effectiveness of error prevention techniques.

A retrospective pilot study was undertaken by the Massachusetts Board of Registration in Pharmacy in an attempt to identify causative factors associated with medication errors. A survey instrument was designed to collect data from pharmacists and consumers regarding their perceptions as to the cause of the medication error in question. The data was collected from available medication error cases brought before the Massachusetts Board of Registration in Pharmacy between June 1996 and July 1997. Only those cases that provided a complete set of data on the survey questionnaire were utilized.

Objective

The Massachusetts Board of Registration in Pharmacy, under the direction of principal investigator, R. Rebecca Couris, M.S., R.Ph., (Assistant Professor of Pharmacy Practice at the Massachusetts College of Pharmacy and Allied Health Sciences, and Ph.D. candidate at Tufts University School of Nutrition Science and Policy), undertook a study to determine the impact of various factors on the incidence of medication errors made by practicing pharmacists in the state of Massachusetts.

Methods

A fifty question survey instrument was developed by the principal investigator (RRC) in cooperation with the Massachusetts Board of Registration in Pharmacy to examine factors associated with medication errors made by practicing pharmacists in the state of Massachusetts. The survey questionnaire incorporated factors deemed relevant by previous studies published in the literature to the occurrence of medication errors in the country. A representative sample of 51 registered pharmacists and the corresponding consumers were asked to participate in this study. These medication error cases, all involving ingestion, were brought before the Massachusetts Board of Registration in Pharmacy between June 1996 and July 1997.


This information is provided by the Division of Health Professions Licensure within the Department of Public Health.