Palliative care study highlights need for more vigilanceJanuary 08 2018
An Australian review of palliative care services has revealed the impact of opioid medication errors on patients in the final weeks of their lives.
In a paper published in BMJ Supportive & Palliative Care today (Monday 8 January), researchers from NSW and the University of South Australia reveal that errors involving opioids are almost three times higher than previously reported in other healthcare settings.
Researchers looked at opioid errors in three inpatient palliative care services in metropolitan NSW over a two-year period, from 2013-2015. More than half of the errors (57 per cent) involved patients receiving a lower dose of pain relief than ordered, requiring clinical intervention in a third of cases. The majority of patients had cancer and were aged in their 70s.
Professor Debra Rowett, from UniSA’s School of Pharmacy and Medical Sciences, says the study highlights the importance of understanding why opioid errors occur - particularly lower dosing - which may contribute to patients’ pain.
“Palliative care clinicians have identified that safe use of opioids is a patient safety priority and this study is an important first step in quantifying and identifying opioid errors,” Professor Rowett says.
“The high rate of errors in palliative care environments compared to other healthcare services most likely reflects the higher volume of opioids such as morphine being used for patients to manage their pain in the last stages of their lives.”
Of 55 opioid errors identified, most involved morphine dosages (35 per cent) and two thirds related to administration errors. Researchers say better understanding the factors that contribute to or mitigate opioid errors is a priority in this clinical setting.
Medication errors pose one of the greatest risk to patient safety, researchers say, particularly those involving opioids, which are high-risk medicines. The risk is amplified in patients who are older, have multiple health issues and are taking numerous medications.
Notes to editors
Opioid errors in inpatient palliative care services: a retrospective review is published in the British Medical Journal. For a copy of the paper please email firstname.lastname@example.org
The review was undertaken by Nicole Heneka and Professor Jane Phillips from the University of Technology, NSW; Professor Tim Shaw, University of Sydney; Professor Debra Rowett, UniSA; and Dr Samuel Lapkin, St George Hospital, Sydney.
Areas of study and research
- Health Research
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)
- Centre for Cancer Biology
- Centre for Drug Discovery and Development
- Centre for Population Health Research
- Centre of Research Excellence for the Prevention of Chronic Conditions in Rural and Remote High Risk Populations
- International Centre for Allied Health Evidence
- Medicine and Device Surveillance CRE
- Quality Use of Medicines and Pharmacy Research Centre
and Social Sciences
- Art, Architecture and Design
- Communication, International Studies and Languages
- Psychology, Social Work and Social Policy
- Hawke Research Institute
- Asia Pacific Centre for Work Health and Safety
- Australian Centre for Child Protection
- Barbara Hardy Institute
- Centre for Research in Education
- Hawke EU Jean Monnet Centre of Excellence
- Centre for Islamic Thought and Education
- International Centre for Muslim and non-Muslim Understanding
- Research Centre for Languages and Cultures
- Zero Waste SA Research Centre for Sustainable Design and Behaviour (sd+b)
IT, Engineering and
- Future Industries Institute
- UniSA College