Medication errors and response bias: the tip of the iceberg.

BACKGROUND Medication errors are a common cause of morbidity and mortality. OBJECTIVES To evaluate the rate of acknowledgment of medication errors as reported by physicians working in the community and in hospitals. METHODS An anonymous questionnaire was sent to 9320 active physicians (about 48% community physicians, 17% hospital physicians and 35% working in both places), with questions on the rate and type of medication errors that they had encountered during their professional career. The questions specified errors in dosage, type of medicine (wrong indication), route of administration and drug interactions. RESULTS Only 627 physicians (6.7%) responded. Of these, nearly 79% admitted having made an error in prescribing medication; the majority admitted to more than one error. Physicians with fewer years of experience admitted having made a mistake more than did physicians with more experience (P = 0.019). Pediatricians and geriatricians made more dosage mistakes (P= 0.02), while family physicians and psychiatrists made more mistakes in drug interactions (P= 0.001). CONCLUSIONS It is possible that indifference, fear of identification, or lack of awareness may have contributed to the low response rate despite the fact that the questionnaire was anonymous. Educational programs should be implemented in medical schools to encourage physicians to report errors before the onset of adverse reactions.