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Common Causes of Medication Errors Relating to Elderly Patients

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Elderly patient receiving treatment at a hospital
According to Ireland’s Institute of Medicine, approximately one medication error occurs per hospital patient per day. Over the course of a year, this equates to three million medication errors occurring in Irish hospitals. A large percentage of those wrongly prescribed medicines are senior citizens. Medication-related adverse events (AEs) are the most common safety incidents in older individuals due to the convergence of three primary factors: aging, multiple medical conditions, and polypharmacy. These factors increase the likelihood of a healthcare professional making a mistake when prescribing medicines.

Here we explore some of the most common causes in more detail, together with guidance on what to do if you or a member of your family has been incorrectly prescribed a medication.

What is polypharmacy and why does it affect elderly patients more frequently?

Polypharmacy refers to the concurrent use of multiple medications by a patient, often for various conditions. It affects elderly patients more frequently because, as people age, they typically accumulate more chronic diseases and conditions that necessitate medication management.

Polypharmacy increases the complexity of a patient’s medication regimen, raising the potential for drug-drug interactions. This complexity can lead to oversights by healthcare providers in recognising harmful combinations. Additionally, with more medications, there’s a greater risk of therapeutic duplication, where multiple drugs of the same class are prescribed. The chance of overlooking contraindications or missing dose adjustments for kidney or liver function also increases. Furthermore, tracking and reconciling multiple medications during healthcare transitions, like hospital admissions or discharges, becomes more challenging, increasing the likelihood of errors.

Is it possible to bring a legal claim for a polypharmacy error?

Yes. If a healthcare provider prescribes medications without adequately considering interactions, contraindications, or a patient’s overall health, they may be deemed negligent. Patients or their representatives can potentially sue for damages stemming from such negligence. However, the feasibility and success of such a claim depend on the specifics of the case and the ability to prove that the error directly caused harm.

What are age-related physiological changes, and how do they affect the prescription of medicines?

Age-related physiological changes refer to the natural alterations in bodily functions and processes as individuals age. These changes can impact drug metabolism, distribution, and elimination. Examples include decreased kidney and liver function, reduced gastrointestinal motility, and alterations in body fat and muscle proportions. Healthcare providers must consider these changes when prescribing medications to ensure appropriate dosing, prevent adverse drug reactions, and achieve the desired therapeutic effect. Overlooking these physiologic shifts can lead to medication-related problems, underscoring the importance of tailoring prescriptions to an elderly individual’s unique physiological profile.

Is it possible to bring a legal claim for negligence in age-related physiological changes?

Yes. If a healthcare provider fails to adjust dosages or consider drug interactions relevant to an elderly patient’s altered physiology, and this oversight directly causes injury or harm, they may be deemed negligent. The viability of such a legal claim hinges on demonstrating that the provider’s oversight deviated from standard care and directly caused harm.

What are healthcare provider knowledge gaps and how do they contribute to medication errors?

Healthcare provider knowledge gaps refer to areas where providers lack sufficient information, awareness, or training regarding specific aspects of patient care. These gaps can stem from rapid advances in medicine, not keeping up with current guidelines, or not receiving adequate education on particular topics. When it comes to medication, knowledge gaps can lead to prescribing the wrong drug, incorrect dosing, or overlooking potential drug interactions. Providers might be unaware of newer medications, their side effects, or best practices for their use. Such gaps, combined with the complexity of patient care, can result in errors that might compromise patient safety and therapeutic outcomes.

Is it possible to bring a legal claim due to suspected knowledge gaps of a healthcare provider?

Yes. If a provider’s lack of knowledge or training directly leads to inappropriate care, misdiagnosis, or harmful treatment, and a patient suffers as a result, this can be grounds for a negligence claim. To succeed, one must typically demonstrate that the provider’s care deviated from the accepted standard of care for their profession and that this deviation directly caused harm.

What is the importance of adequate patient education?

Adequate patient education is crucial for ensuring patients understand their conditions, treatments, and potential risks, promoting adherence to medical regimens and informed decision-making. Inadequate education can lead to medication misuse, non-adherence, or misunderstanding of treatment plans. This can result in preventable side effects, exacerbation of illness, increased hospitalisations, and even life-threatening conditions. For example, a patient unaware of the importance of taking an antibiotic course fully might stop early, leading to drug resistance. Similarly, not understanding the side effects of a new medication can result in harmful interactions or failure to recognise adverse reactions in time.

Is it possible to bring a legal claim due to inadequate patient education?

Yes. If a healthcare provider fails to adequately inform a patient about the nature, risks, benefits, or alternatives of a treatment, and the patient suffers harm as a result, this may be grounds for an “informed consent” legal claim. A successful claim requires demonstrating that the provider failed to provide informed consent, directly leading to harm to the patient. However, these types of claims can be very hard to prove, and seeking counsel from legal professionals is highly advised.

Require legal advice regarding a medication error?

The McCarthy + Co team has over 30 years’ experience bringing successful medical negligence claims, including cases relating to medication errors. If you, or a member of your family, has suffered due to errors in the administration of medicines, you may have the basis to bring a claim. Call us on 1800 390 555 and an experienced member of staff will discuss your situation and potential next steps. You can also email info@mccarthy.ie and we will get back to you as soon as we can.

John McCarthy

John McCarthy is a seasoned solicitor with almost 20 years of experience, specialises in personal injury and medical negligence claims, focusing particularly on high-value compensation cases. His extensive litigation experience spans Circuit Court, High Court and Supreme Court levels. John's practice involves a diverse range of cases, from personal injury and wrongful death to property damage, defective products, professional negligence and judicial reviews.

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