Medication Errors in Psychiatry: Are Patients Being Harmed?
AbstractOur patients deserve to know the risks they incur during hospitalization as well the benefits. One of the risks is unintended harm from medication errors. Recent reports by the Institute of Medicine suggest that errors in inpatient settings are associated with thousands of deaths and that they cost many millions of dollars annually. Of the slightly more than one million hospitalizations in the United States in 1998, 25.8 percent were psychiatric admissions. Therefore, the number of psychiatric inpatients at risk of unintended harm and suboptimal care is substantial. Unfortunately, few reports have been published on rates of error or adverse events in psychiatry, and there has been little commentary on related methodological issues. Some prominent psychiatric journals do not even include "medication errors" or "adverse drug events" as keyword options for submitted manuscripts. A MEDLINE search for reports on medication errors and related topics yielded only 44 articles, two of which originated from psychiatric settings. Without more research, the risk of unintended harm from medication errors in psychiatry will remain unknown. What most institutions do know about errors most likely comes from risk management assessments and spontaneous reports at monthly staff meetings. Error rates are generally calculated by