Emotional and physical distress of medication errors reported to a German poison information centre: a prospective follow-up study among patients and caregivers

Medication errors can lead to clinically severe symptoms. They can occur at any stage of the medication process, including medication administration by patients or caregivers. Previous research indicates that such medication errors represent a considerable proportion of enquiries to poison information centres. In this prospective study, we evaluated enquiries by patients and caregivers to a poison information centre to identify medication errors likely committed by them. Standardized follow-up interviews were conducted to evaluate characteristics, types and contributing factors, clinical outcomes, physical and emotional distress, and preventive strategies. Physical and emotional distress were assessed using Likert scales from 0 (no distress) to 10 (strong distress). Among 304 enquiries concerning medication errors, most (66.4%; 202/304) were committed by caregivers. The most frequent medication error was drug mix-up (59.9%; 182/304); contributing factors included product design (33.9%; 103/304). Most patients (77.6%; 236/304) did not experience symptoms, and severe symptoms were not observed. Reported physical distress (subjective perception of physical strain such as pain, nausea or general discomfort) was generally low in patients (median 0 [IQR: 0–5]) and caregivers (median 0 [IQR: 0-0]). In contrast, emotional distress (the psychological suffering experienced by patients and caregivers because of the medication error, for example, anxiety, helplessness, or uncertainty) was considerably higher, with a median of 8 (IQR: 5–9) reported by patients and 8 (IQR: 6–10) by caregivers. Patients or caregivers intended to prevent future medication errors by improving medication storage (23.2%; 78/336), handling (17.3%; 58/336), and labelling (11.3%; 38/336). Although most medication errors did not cause physical symptoms, uncertainty, fear of harm, and guilt contributed to significant emotional distress. When considering drug therapy, emotional distress should be considered in addition to clinical severity. Medication errors by patients and caregivers (parents) are common. They rarely cause physical harm but often lead to considerable emotional distress. Support offered by poison information centres may reduce emotional distress.