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TED R. MIKULS, JEFFREY R. CURTIS, JEROAN J. ALLISON, RODNEY W. HICKS, and KENNETH G. SAAG ABSTRACT. Methods. We examined data from the MEDMARXTM database, covering the period from January 1, 1999 through December 31, 2003. For allopurinol and colchicine, we examined error severity, source, type, contributing factors, and healthcare personnel involved in errors, and we detailed errors resulting in patient harm. Causes of error and the frequency of other error characteristics were compared for gout medications versus other musculoskeletal treatments using the chi-square statistic. Results. Gout medication errors occurred in 39% (n = 273) of facilities participating in the MEDMARX program. Reported errors were predominantly from the inpatient hospital setting and related to the use of allopurinol (n = 524), followed by colchicine (n = 315), probenecid (n = 50), and sulfinpyrazone (n = 2). Compared to errors involving other musculoskeletal treatments, allopurinol and colchicine errors were more often ascribed to problems with physician prescribing (7% for other therapies versus 23–39% for allopurinol and colchicine, p < 0.0001) and less often due to problems with drug administration or nursing error (50% vs 23–27%, p < 0.0001). Conclusion. Our results suggest that inappropriate prescribing practices are characteristic of errors occurring with the use of allopurinol and colchicine. Physician prescribing practices are a potential target for quality improvement interventions in gout care. (J Rheumatol 2006;33:562–6)
Key Indexing Terms: GOUT From the Department of Medicine, University of Nebraska Medical Center and the Omaha VA Medical Center, Omaha, NE; Center for Education and Research in Therapeutics (CERT) in Musculoskeletal Disorders, University of Alabama at Birmingham, Birmingham, AL; and United States Pharmacopeia (USP), Rockville, MD, USA. Drs. Mikuls and Saag have served as consultants to Tap Pharmaceuticals. Mr. Hicks is an employee of US Pharmacopeia. T.R. Mikuls, MD, MSPH, Department of Medicine, University of Nebraska Medical Center and Omaha VA Medical Center; J.R. Curtis, MD, MPH; J.J. Allison, MD, MS, CERT in Musculoskeletal Disorders, University of Alabama at Birmingham; R.W. Hicks, RN, MSN, MPA, USP; K.G. Saag, MD, MSc, CERT in Musculoskeletal Disorders, University of Alabama at Birmingham. Address reprint requests to Dr. K.G. Saag, Department of Medicine, Division of Clinical Immunology and Rheumatology, 510 20th Street South, FOT 8th Floor, Birmingham, AL 35294, USA. E-mail: ksaag@uab.edu Accepted for publication November 2, 2005.
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