The Pharmaceutical Journal
Vol 280 No 7490 p206
23 February 2008

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Depressed doctors make more drug errors

Depression among paediatricians is associated with a six-fold increase in medication errors, a US study suggests (BMJ Online First, 7 February 2008). A leading paediatric pharmacist believes that this provides evidence for more pharmacist input to medical training.

Medication error rates were recorded for 123 doctors on paediatric rotations. Assessments were also made of symptoms of depression and burnout, a syndrome of mental exhaustion and personal detachment that develops in response to chronic occupational stress.

One fifth of the doctors taking part met criteria for depression and three quarters met criteria for burnout. Although burnout did not seem to increase medication errors, depressed paediatricians made 6.2 times as many medication errors as those who were not depressed.

The researchers conclude that mental health may be a more important contributor to medication errors than previously suspected. Efforts should be made to screen doctors for signs of depression and ensure appropriate treatment is provided, they say.

The authors of an accompanying editorial (ibid) point out the small sample size used in the investigation and suggest that larger studies are needed to clarify the impact of individual factors on error rates.

Steve Tomlin, principal paediatric pharmacist at Guy’s and St Thomas’ NHS Foundation Trust, London, believes that the study’s findings are unlikely to be specific to paediatric doctors. However, he told The Journal that errors in medication in children are often of a magnitude not seen in adults due to higher use of decimal point calculations and inappropriate formulations.

“This study might say many things about the way that doctors work, but indirectly it should lead pharmacists to play a greater role in doctor training, risk analysis and medicines management,” he said.

“Medication errors are generally multifactorial and pharmacists should play a major role in introducing barriers to prevent errors — whatever their cause — reaching patients and especially vulnerable children.”