A FIFTH of children treated for leukaemia may not receive the appropriate chemotherapy regime because of medication errors, a study suggests.

The research, published in the journal Cancer, involved 69 children who were treated as outpatients, receiving 172 medications between them.

In all, 17 errors were detected either in the way the drugs were administered or in the size of the doses prescribed. None of the mistakes were caused by dispensing chemists. The errors affected 13 children.

The scientists, from the University of Washington and the Children’s Hospital and Regional Medical Centre in Seattle, found that there was little clinical impact from the errors in 9 of the 13 children.

But serious mistakes affected four children. Three did not receive medications at the right times, increasing the risk of relapse, and one received an overdose, creating a greater risk of life-threatening infection.

Leukaemia accounts for one third of all childhood cancers, with about 500 cases among under-15s diagnosed in Britain each year.

Although the study was conducted in the US, research suggests that medical error rates are similar in most Western health settings. Medication errors involving outpatients are thought to be more common than those involving inpatients. These can occur during prescribing, during interpretation and processing by pharmacists, and when administered by patients or carers.

The authors said that most mistakes involving outpatients were caught before they received the drugs. They added that because most drugs had wide safety ranges, most errors were benign. However, children with cancer receive toxic drugs with narrow safety ranges that must be prescribed according to strict protocols.

The lead author, James Taylor, said: “It is possible that the efficacy of treatment regimens is reduced or toxicity increased because not all children are receiving the chemotherapeutic agents as indicated.”

The study recommended that, when designing new chemotherapy treatments, a balance should be struck between precision and simplicity to minimise the risk of errors.

Last week the Healthcare Commission urged the NHS to improve how it prescribed and dispensed drugs after figures showed that 40,000 mistakes were made in the 12 months to July. Most of the errors caused no harm, but 2,000 led to moderate or severe harm and 36 to death.

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