KEY FACTS ABOUT MEDICATION ERRORS

(MEs) IN THE WHO EUROPEAN REGION

WHAT IS A MEDICATION ERROR?
A medication error is defined as “any preventable event that may cause or lead to
inappropriate medication use or patient harm while the medication is in the control of the
health-care professional, patient, or consumer” (1). Medication harm accounts for more
than half of the overall preventable harm in medical care globally, with an estimated annual
cost of €4.5–21.8 billion in Europe (2).

€2 billion 237 million

The cost of medication • Another study found that there are approximately
errors was estimated 237 million medication errors over a year in one country;
at €2 billion in one 66 million are potentially clinically significant. The estimated
of the countries costs for the government in avoidable adverse reactions
(representing 3% of the to medication are £98.5 million a year.
total national health-
• This comprises primary care adverse drug events
care expenditure) (3).
(ADEs) leading to hospital admission (£83.7 million;
causing 627 deaths), and secondary care ADEs
leading to longer hospital stay (£14.8 million; causing
or contributing to 1081 deaths) (4).

Some of the common factors

leading to medication errors
in hospitals include
environmental, staffing
or workflow problems.

Electronic prescription,
medication error
In Europe there is great variation in terms surveillance and barcode Evidence on MEs shows that
of the scale and nature of this harm. medication administration 50–70.2% of such harm can
The rate of medication error in hospitals systems are the most be prevented through
ranges from 0.3% to 9.1% in prescriptions, important areas in comprehensive systematic
from 1.6% to 2.1% at the dispensing stage. (3) which to reduce MEs (3). approaches to patient safet (5).

References

1. What is a medication error? New York, NY: National Coordinating Council for Medication Error Reporting and Prevention; 2015
(http://www.nccmerp.org/ about-medication-errors, accessed 3 August 2022).

2. Hodkinson A, Tyler N, Ashcroft DM, Keers RM, Khan K, Phipps D et al. Preventable medication harm across health care settings: a systematic review and meta-analysis.
BMC Med. 2020;18(1):313.
3. The urgent need to reduce medication errors in hospitals to prevent patient and second victim harm [White paper]. European Collaborative Action On Medication Errors and
Traceability (ECAMET); 2022 (https://eaasm.eu/wp-content/uploads/ECAMET-White-Paper-Call-to-Action-March-2022-v2.pdf, accessed 5 August 2022).
4. Elliott RA, Camacho E, Jancovic D, Sculpher MJ, Faria R. Economic analysis of the prevalence and clinical and economic burden of medication error in England.
BMJ Qual Saf. 2021;30:96–105 (https://qualitysafety.bmj.com/content/qhc/30/2/96.full.pdf, accessed 3 August 2022).
5. Adler L, Denham CR, McKeever M, Purinton R, Guilloteau F et al. Global trigger tool: implementation basics. J Pat Saf. 2008;4:245–9.
WHAT ARE THE COMMON MEs?
Several different types of MEs are possible. These can relate to drug prescription or administration,
timing, communication, human error, among others.

25%
MOST
COMMON MEs
Examples of the most
common types of MEs
25% of patients with type 2 reported are incorrect
diabetes suffered at least dosage (34.7%), omission
one drug error, mostly due to of a dose (40.0%), and
prescribing a wrong dose (6). wrong administration
speed (7).

References
6. Mader JK, Aberer F, Drechsler KH, Pottler T, Lichtenegger KM, Kole W et al. Medication errors in type 2 diabetes from pateints’ perspective. PLoS One. 2022;17(4):e0267570.
7. Delgado MCM, Alvarez JT, Lopez ES, Gomez MR, Galindo AS, Moro MN et al. Medication error prevention in adult, paediatric and neonate intensive care units in Spain.
Madrid: PREVEMED (https://semicyuc.org/wp-content/uploads/2022/05/20220427_INFORME-PREVEMED-INGLES-002.pdf, accessed 5 August 2022).

WHY DO MEs OCCUR?

• MEs can occur due to weak medication systems, human factors such as fatigue, or poor work
conditions such as heavy workload and staff shortages (8).

• Health-care staff directly or indirectly involved in such adverse events, also referred to as the
“second victims”, may suffer from serious emotional harm as a result.

WORK MENTAL
HEALTH
LOAD It is estimated that more than
1 in 10 nurses suffering from
Heavy workload and mental and psychosocial health
lack of health-care disorders have been involved in
personnel contribute an adverse event with serious
to to more than 20% consequences for the patient,
of MEs, according mainly during the COVID-19
to estimates (3). pandemic (9).

References
8. Medication without harm: global patient safety challenge on medication safety. Geneva: WHO; 2017 (https://www.who.int/publications/i/item/WHO-HIS-SDS-2017.6,
accessed 3 August 2022).
9. Mental and psychosocial health in healthcare; preventing medication errors and adverse events and disorders in healthcare workers. Brussels: European Biosafety Network
(https://www.europeanbiosafetynetwork.eu/mental-and-psychosocial-health-in-healthcare-preventing-medication-errors-and-adverse-events-and-disorders-in-healthcare-workers/,
accessed 3 August 2022).

WHO Office on Quality of Care and

Patient Safety (Athens, Greece)
WHEN DO MEs OCCUR?
MEs can happen at any of the following stages – during prescription, transcription, preparation,
dispensing, administration and/or monitoring.

29%
29% of patients have unintended
ERRORS
Distribution of errors in one country by
phases of medicine use has been reported as:
medication discrepancies (UMDs) prescribing (21.3%), transcription (1.4%),
and MEs at admission or at dispensing (15.9%), administration (54.4%)
discharge from hospital (10). and monitoring (7.0%) (3).

Reference
10. Breuker C, Macioce V, Mura T, Casete-Nicolas A, Audurier Y, Boegner C et al. Medication errors at hospital admission and discharge: risk factors and impact of medication
reconciliation process to improve healthcare. J Pat Saf. 2021;17(7):e645–e652
(https://journals.lww.com/journalpatientsafety/Abstract/2021/10000/Medication_Errors_at_Hospital_Admission_and.17.aspx, accessed 3 August 2022).

WHAT CAN BE DONE TO PREVENT MEs?

WHO recommends prioritizing the following three areas to avoid MEs and to protect patients from
medication harm (11).

High-risk situations: understanding Polypharmacy: the standardization of Transition of care: transition of care
situations where evidence shows that policies, procedures and protocols is increases the possibility of
there is a higher risk of harm from critical in the case of poly-pharmacy. communication errors, which can
particular medicines is key. Tools and This is applicable from initial prescribing lead to serious MEs. Good communication
technologies may help health-care practices to regular medication reviews. is vital, including a formal comparison
professionals who use high-alert Technology can also serve as a useful of medicines pre- and post-care,
medications, and also enhance patient aid by enhancing patient awareness and so-called medication reconciliation.
knowledge and understanding of knowledge about the medication use
these medications. process.

Reference
11. Medication without harm: global patient safety challenge on medication safety. Geneva: WHO; 2017 (https://www.who.int/publications/i/item/WHO-HIS-SDS-2017.6,
accessed 3 August 2022).

ADDITIONAL WHO RESOURCES

Medication without harm: global patient safety challenge on medication safety. Strategic Framework. Geneva: WHO; 2017
(https://cdn.who.int/media/docs/default-source/patient-safety/strategic-framework-medication-without-
harm86c06fafdf0b4294bd23ec9667dfb95d.pdf?sfvrsn=b5cb2d66_2, accessed 5 August 2022).

Medication safety in polypharmacy. Geneva: World Health Organization; 2019 (WHO/UHC/SDS/2019.11). Licence: CC BY-NC-SA 3.0 IGO.

Medication safety in transitions of care. Geneva: World Health Organization; 2019 (WHO/UHC/SDS/2019.9). Licence: CC BY-NC-SA 3.0 IGO.

Medication afety in high-risk situations. Geneva: World Health Organization; 2019 (WHO/UHC/SDS/2019.10). Licence: CC BY-NC-SA 3.0 IGO.

WHO Office on Quality of Care and

Patient Safety (Athens, Greece)

© World Health Organization 2022. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO