Assessment of medication use process in adult oncology unit of Tikur Anbesa Specialized Hospital: A cross-sectional study in Addis Ababa, Ethiopia

Background: Chemotherapy errors affect several steps of medication-use process. A reduction of errors and toxicities, and an increase in error awareness, dose verification, proper documentation, and appropriateness of supportive care treatment are important. The present study was conducted to assess the medication-use process and dose-related errors in an outpatient adult oncology unit of Tikur Anbesa Specialized Hospital. Methods: An institutional-based cross-sectional study was conducted in an oncology outpatient adult oncology unit of Tikur Anbesa Specialized Hospital between May 1 and June 30, 2012. A total of 212 patient records for 583 chemotherapy administrations were reviewed during the study period. Results: The overall dose-related error rate was found to be 228 (39.1%). Specific rate of dose-related errors were (under dosing 58 (25.4%), overdosing 52 (22.8%), inaccurately reconstituted doses 106 (46.5%), and inappropriately adjusted doses 12 (5.3%). Dose labeling and documentation of appropriate time of administration for each chemotherapy preparation were not evident in the unit records. Only 3/14 dose verifications and 3 dose documentation processes were found. Supportive care treatment was not performed according to the recommended standards. Of the 23 equipment and supplies needed for chemotherapy preparation and administration, only 8 were available. Conclusions: The findings of our study indicate that the medication-use process in an outpatient adult oncology unit was below expected standards in 2012. The hospital and the school of pharmacy should give emphasis on the establishment of pharmacist run oncology pharmacy for chemotherapy preparation. Policies and guidelines for chemotherapy mixing and administration service and standardization of the process workflow should be developed.