Medication errors may be common in children with leukemia or lymphoma, and these errors can lead to serious harm, according to a study published in Cancer

Nearly 80% of children studied had at least 1 medication error, and 10% of children were harmed by a medication error. Most errors occurred during at-home administration.

This study included 131 children from 3 pediatric cancer centers who were taking medications at home for leukemia or lymphoma. The researchers conducted 367 home visits to these children, who were taking a combined 1669 medications. Errors were identified using chart review, in-home medication review, observation of administration, and caregiver interviews. 

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The median number of medications per child was 12 (range, 2-33). In most cases (82%), the mother was the primary person responsible for administering medications, but 86% of patients had multiple caregivers who administered medication. 

The majority (79%) of children had at least 1 medication error. The overall rate was 12.4 errors per 1000 patient-days. 

Forty-two percent of children had at least 1 error with the potential for harm (242 errors). These were most often errors with at-home administration (78%), followed by prescribing errors (18%), errors occurring during administration in the clinic (2%), and dispensing errors (2%). 

Ten percent of children had harm from a medication error (39 errors). Most of these errors (92%) resulted in significant harm (temporary harm that required intervention), and 8% resulted in serious harm (temporary harm that resulted in hospitalization). 

Most errors (80%) that led to harm occurred due to administration at home, and 20% were prescribing errors. 

Children who were on 13 or more medications were significantly more likely to have serious medication errors than those on fewer medications (77% vs 61%; P =.05). 

The researchers noted that patients having multiple caregivers was a major source of miscommunication and medication errors. Twenty-eight percent of caregivers reported administering a double dose of medication or missing a dose due to miscommunication with another caregiver. 

Failure by a caregiver to communicate treatment changes following provider encounters was another common source of errors.

“To prevent medication errors at home, our findings provide further evidence of the urgent need for improved communication between the health care system, the patient, and caregivers,” the researchers concluded. 

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Wong CI, Vannatta K, Marchak JG, et al. Preventable harm because of outpatient medication errors among children with leukemia and lymphoma: A multisite longitudinal assessment. Cancer. Published online January 27, 2023. doi:10.1002/cncr.34651