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Multicenter Study
. 2008 Mar 1;336(7642):488-91.
doi: 10.1136/bmj.39469.763218.BE. Epub 2008 Feb 7.

Rates of medication errors among depressed and burnt out residents: prospective cohort study

Amy M Fahrenkopf  1 , Theodore C Sectish, Laura K Barger, Paul J Sharek, Daniel Lewin, Vincent W Chiang, Sarah Edwards, Bernhard L Wiedermann, Christopher P Landrigan
Affiliations
Multicenter Study

Rates of medication errors among depressed and burnt out residents: prospective cohort study

Amy M Fahrenkopf et al. BMJ. .

Abstract

Objective: To determine the prevalence of depression and burnout among residents in paediatrics and to establish if a relation exists between these disorders and medication errors.

Design: Prospective cohort study.

Setting: Three urban freestanding children's hospitals in the United States.

Participants: 123 residents in three paediatric residency programmes.

Main outcome measures: Prevalence of depression using the Harvard national depression screening day scale, burnout using the Maslach burnout inventory, and rate of medication errors per resident month.

Results: 24 (20%) of the participating residents met the criteria for depression and 92 (74%) met the criteria for burnout. Active surveillance yielded 45 errors made by participants. Depressed residents made 6.2 times as many medication errors per resident month as residents who were not depressed: 1.55 (95% confidence interval 0.57 to 4.22) compared with 0.25 (0.14 to 0.46, P<0.001). Burnt out residents and non-burnt out residents made similar rates of errors per resident month: 0.45 (0.20 to 0.98) compared with 0.53 (0.21 to 1.33, P=0.2).

Conclusions: Depression and burnout are major problems among residents in paediatrics. Depressed residents made significantly more medical errors than their non-depressed peers; however, burnout did not seem to correlate with an increased rate of medical errors.

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Conflict of interest statement

Competing interests: None declared.

Figures

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Fig 1 Rates of medication errors per resident month for depressed compared with non-depressed residents and for burnt out compared with non-burnt out residents. T bars indicate 95% confidence intervals. P value determined using Poisson cluster analysis
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Fig 2 Rates of self reported medical errors for depressed compared with non-depressed residents and burnt out compared with non-burnt out residents. P values calculated using Fisher’s exact test
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Fig 3 Health and job performance ratings for depressed and non-depressed residents. P values calculated using Fisher’s exact test
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Fig 4 Health and job performance ratings for burnt out and non-burnt out residents. P values calculated using Fisher’s exact test
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