The influence of formulation and medicine delivery system on medication administration errors in care homes for older XXXX .

@entity1 @entity262
INTRODUCTION: Older @entity1 in care homes are at increased risk of medication errors and adverse drug events. The effect of formulation on administration errors is not known, that is whether the medicine is a tablet or capsule, liquid or device such as an inhaler. Also, the impact on administration errors of @entity262 ( @entity262 ), commonly used in UK care homes to dispense tablets and capsules, is not known. This study investigated the influence of formulation and @entity262 on administration errors. METHODS: Administration errors were identified by pharmacists (using validated definitions) observing two drug rounds of residents randomly selected from a purposive sample of UK nursing and residential homes. Errors were classified and analysed by formulation and medicine delivery system. RESULTS: The odds of administration errors by formulation, when compared with tablets and capsules in @entity262 , were: liquids 4.31 (95% CI 2.02 to 9.21; p = 0.0002); topicals/transdermals/injections 19.61 (95% CI 6.90 to 55.73; p < 0.0001); inhalers 33.58 (95% CI 12.51 to 90.19; p < 0.0001). The odds of administration errors for tablets and capsules not in @entity262 were double those that were dispensed in @entity262 (adjusted OR 2.14, 95% CI 1.02 to 4.51; p = 0.04). CONCLUSIONS: Inhalers and liquid medicines were associated with significantly increased odds of administration errors. Training of staff in safe administration of these formulations needs implementing. Although there was some evidence that @entity262 reduced the odds of an administration error, the use of @entity262 impacts on other aspects of medicines management. Because of this, and as the primary topic of our study was not @entity262 , a prospective trial specifically designed to evaluate the overall impact of @entity262 on medicine management in care homes is needed.
